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Synthetic cannabinoid receptor agonists (SCRAs) may be used as an alternative to natural cannabis; however, they may carry a greater risk of problematic use and withdrawal. This study aimed to characterise the withdrawal symptom profile of SCRAs and compare their profile of effect with high-potency herbal cannabis. Global Drug Survey data (2015 and 2016) were used to access a clinically relevant sample of people reporting use of SCRAs >10 times in the past 12-months, a previous SCRA quit attempt, and lifetime use of high-potency herbal cannabis. Participants completed an 11-item SCRA withdrawal symptom checklist and compared SCRAs and high-potency herbal cannabis on their onset and duration of effects, speed of the development of tolerance, severity of withdrawal, and difficulty with dose titration. Participants (n = 284) reported experiencing a mean of 4.4 (95% CI: 4.1, 4.8) withdrawal symptoms after not using SCRAs for >1 day; most frequently reported were sleep issues (59.2%), irritability (55.6%), and low mood (54.2%). Withdrawal symptoms were significantly associated with frequency (>51 vs. 11-50 times per year: IRR = 1.43, 95% CI: 1.16, 1.77, p = 0.005) and quantity (grams per session: IRR = 1.13, 95% CI: 1.05, 1.22, p = 0.001) of SCRA use. Compared to high-potency herbal cannabis, SCRAs were rated as having a faster onset and shorter duration of effects, faster development of tolerance, and more severe withdrawal (p's < 0.001). In conclusion, SCRA withdrawal symptoms are more likely to occur after greater SCRA exposure. The effects of SCRA indicate a more severe withdrawal syndrome and a greater risk of problematic use than natural cannabis., (© 2021. The Author(s).)

Background: With the growth of legal cannabis markets there has been recognition of the adverse impacts of certain cannabis growing practices, notably, use of harmful chemicals. A major concern has been the use of Plant Growth Regulators (PGRs) which limit plant size and stimulate bud production. These chemicals, many of which have been banned from food crops, have been found unlisted in cannabis growing nutrients sold online or in hydroponic stores. This study describes the cannabis growing practices used by small-scale recreational cannabis growers and specifically their self-reported use of chemicals., Methods: Web survey data from 1722 current and recent cannabis growers in Australia, Denmark, and the UK, who were asked about their cannabis growing practices, including the use of fertilizers and supplements., Results: Overall 44% of the sample reported using any chemical fertilizers, supplements or insecticides. Logistic regression indicated that the unique predictor of the use of chemicals was growing hydroponically., Conclusion: Problems associated with product labeling and uncertainty regarding product constituents made it difficult for growers and the researchers to determine which products likely contained PGRs or other harmful chemicals. There is a need for further research to analyze constituents of chemical products marketed to cannabis growers., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: How cannabis cultivation is dealt with under various examples of cannabis legalization or regulation is an important consideration in design of such schemes. This study aimed to (i) investigate support among current or recent cannabis growers, for various potential policy options for cannabis cultivation if prohibition were repealed, and (ii) explore the support for these options across countries, scale of growing operations, demographics, drug use and cannabis supply involvement variables., Methods: This study utilized data from the online web survey of largely 'small-scale' cannabis cultivators, aged 18yrs and over, in eleven countries conducted by the Global Cannabis Cultivation Research Consortium (GCCRC). Data from 1722 current and recent cannabis growers in Australia, Denmark and the UK, who were all asked about policy, were included in the analysis. It investigated support for various frameworks for cultivation: (no regulation (free market); adult only; growing licenses; restrictions on plant numbers; licensed business-only sale; approved commercial growing; etc.). Among current growers, support for these options were compared across countries, across scale of growing operations, and by demographics, drug use and crime variables., Results: Although there were some between country differences in support for the various policy options, what was striking was the similarity of the proportions for each of the eight most popular policy options. Among current growers, many of these positions were predicted by demographic, drug use and cannabis growing variables which were conceptually congruent with these positions., Conclusion: The results have relevance for the provisions regarding cannabis cultivation in the design of new non-prohibitionist models of cannabis which are increasingly under consideration. It should be of interest to policy makers, drug policy researchers, law enforcement and cannabis cultivators., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: Internet-mediated research methods are increasingly used to access hidden populations. The International Cannabis Cultivation Questionnaire (ICCQ) is an online survey designed to facilitate international comparisons into the relatively under-researched but increasingly significant phenomenon of domestic cannabis cultivation. The Global Cannabis Cultivation Research Consortium has used the ICCQ to survey over 6000 cannabis cultivators across 11 countries. In this paper, we describe and reflect upon our methodological approach, focusing on the digital and traditional recruitment methods used to access this hidden population and the challenges of working across multiple countries, cultures and languages., Methods: Descriptive statistics showing eligibility and completion rates and recruitment source by country of residence., Results: Over three quarters of eligible respondents who were presented with the survey were included in the final sample of n=6528. English-speaking countries expended more effort to recruit participants than non-English-speaking countries. The most effective recruitment modes were cannabis websites/groups (33%), Facebook (14%) and news articles (11%). While respondents recruited through news articles were older, growing practice variables were strikingly similar between these main recruitment modes., Conclusion: Through this process, we learnt that there are trade-offs between hosting multiple surveys in each country vs. using one integrated database. We also found that although perceived anonymity is routinely assumed to be a benefit of using digital research methodologies, there are significant limits to research participant anonymity in the current era of mass digital surveillance, especially when the target group is particularly concerned about evading law enforcement. Finally, we list a number of specific recommendations for future researchers utilising Internet-mediated approaches to researching hidden populations., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: This article aims to provide an overview of: demographic characteristics; experiences with growing cannabis; methods and scale of growing operations; reasons for growing; personal use of cannabis and other drugs; participation in cannabis and other drug markets; contacts with the criminal justice system for respondents to an online survey about cannabis cultivation drawn from eleven countries (N=6530). Important similarities and differences between the national samples recruited will be discussed., Methods: This paper utilizes data from the online web survey of predominantly 'small-scale' cannabis cultivators in eleven countries conducted by the Global Cannabis Cultivation Research Consortium (GCCRC). Here we focus primarily on descriptive statistics to highlight key similarities and differences across the different national samples., Results: Overall there was a great deal of similarity across countries in terms of: demographic characteristics; experiences with growing cannabis; methods and scale of growing operations; reasons for growing; use of cannabis and other drugs; participation in cannabis and other drug markets, and; contacts with the criminal justice system. In particular, we can recognise that a clear majority of those small-scale cannabis cultivators who responded to our survey are primarily motivated for reasons other than making money from cannabis supply and have minimal involvement in drug dealing or other criminal activities., Conclusions: These growers generally come from 'normal' rather than 'deviant' backgrounds. Some differences do exist between the samples drawn from different countries suggesting that local factors (political, geographical, cultural, etc.) may have some influence on how small-scale cultivators operate, although differences in recruitment strategies in different countries may also account for some differences observed., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: The production and consumption of cannabis for the treatment of medical conditions is of increasing importance internationally; however, research on different aspects of the phenomenon is still scarce. In this article, we report findings from a cross-cultural study of small-scale cannabis cultivation for medical purposes. This kind of comparative study has not been done previously., Methods: The data were gathered with a help of web surveys conducted by the Global Cannabis Cultivation Research Consortium (GCCRC) in Australia, Belgium, Denmark, Finland, Germany and the UK (N=5313). In the analysis we compare reports of medical motives, for what conditions cannabis is used, whether users have diagnoses for these conditions and whether the use of cannabis been recommended as a treatment of those conditions by a medical doctor. Descriptive statistics are used to show the main commonalities and noteworthy disparities across different countries., Results: Findings from countries were quite similar, even though several national differences in details were found. Growing cannabis for medical purposes was widespread. The majority of medical growers reported cultivating cannabis for serious conditions. Most of them did have a formal diagnosis. One fifth had got a recommendation from their doctor, but in most cases cannabis use was self-medication which was not discussed with their doctors., Conclusion: There is a wider demand for licit access for medical cannabis than currently available in these countries. Ideologically, medical growers can be seen distancing themselves from both the legal and illicit drug markets. From a harm reduction perspective, it is worrying that, in the context of present health and control policies in these countries, many medical growers are using cannabis to treat serious medical conditions without proper medical advice and doctor's guidance., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: Having first appeared in Europe, synthetic cannabis emerged as a drug of concern in Australia during 2011. Kronic is the most well-known brand of synthetic cannabis in Australia and received significant media attention. Policy responses were reactive and piecemeal between state and federal governments. In this paper we explore the relationship between media reports, policy responses, and drug-related harm., Methods: Google search engine applications were used to produce time-trend graphs detailing the volume of media stories being published online about synthetic cannabis and Kronic, and also the amount of traffic searching for these terms. A discursive analysis was then conducted on those media reports that were identified by Google as 'key stories'. The timing of related media stories was also compared with self-reported awareness and month of first use, using previously unpublished data from a purposive sample of Australian synthetic cannabis users., Results: Between April and June 2011, mentions of Kronic in the media increased. The number of media stories published online connected strongly with Google searches for the term Kronic. These stories were necessarily framed within dominant discourses that served to construct synthetic cannabis as pathogenic and created a 'moral panic'. Australian state and federal governments reacted to this moral panic by banning individual synthetic cannabinoid agonists. Manufacturers subsequently released new synthetic blends that they claimed contained new unscheduled chemicals., Conclusion: Policies implemented within in the context of 'moral panic', while well-intended, can result in increased awareness of the banned product and the use of new yet-to-be-scheduled drugs with unknown potential for harm. Consideration of regulatory models should be based on careful examination of the likely intended and unintended consequences. Such deliberation might be limited by the discursive landscape., (Copyright © 2012 Elsevier B.V. All rights reserved.)

'Marginal deterrence' refers to deterrence of a more harmful act because its expected sanction exceeds that for a less harmful act. 'Legitimacy of the law' predicts that laws perceived as fair will generate compliance and laws perceived as unfair will generate defiance. The introduction of the Cannabis Infringement Notice (CIN) scheme in Western Australia provided an opportunity to test these theories by assessing whether perceptions of certainty, severity and fairness of punishments dictated by the CIN scheme would affect how regular cannabis users intended to obtain cannabis after legislative change. One hundred Perth residents (mean age 32.2 years; two-thirds male) who reported using cannabis at least once a week were given semi-structured interviews before the CIN scheme came into effect. There was limited opportunity for the CIN scheme to effect marginal deterrence, as most of the sample were already purchasing or growing within the lower penalty thresholds. However, of the minority who were purchasing and growing outside the CIN scheme, a significant proportion reported intending to change their behaviour to fit within the scheme, including the only purchaser of more than 30 g and six of 14 non-hydroponic growers of three or more plants. Perceived certainty, severity and fairness of penalties were not as important in determining purchasing and growing behaviour as factors such as 'meeting needs', 'cost' and 'preference'. The results suggest that under the CIN scheme, marginal deterrence and legitimacy will probably play only a small or selective role in decisions about obtaining cannabis, although in some areas, such as the numbers of non-hydroponic plants, marginal deterrence may be evident.

The effect on the cannabis market is one area of interest in the evaluation of the new 'prohibition with civil penalties' scheme for minor cannabis offences in WA. One goal of the scheme is to reduce the proportion of cannabis consumed that is supplied by large-scale suppliers that may also supply other drugs. As part of the pre-change phase of the evaluation, 100 regular (at least weekly) cannabis users were given a qualitative and quantitative interview covering knowledge and attitudes towards cannabis law, personal cannabis use, market factors, experience with the justice system and impact of legislative change. Some 85% of those who commented identified the changes as having little impact on their cannabis use. Some 89% of the 70 who intended to cultivate cannabis once the CIN scheme was introduced suggested they would grow cannabis within the two non-hydroponic plant-limit eligible for an infringement notice under the new law. Only 15% believed an increase in self-supply would undermine the large scale suppliers of cannabis in the market and allow some cannabis users to distance themselves from its unsavoury aspects. Only 11% said they would enter, or re-enter, the cannabis market as sellers as a result of the scheme introduction. Most respondents who commented believed that the impact of the legislative changes on the cannabis market would be negligible. The extent to which this happens will be addressed in the post-change phase of this research. Part of the challenge in assessing the impact of the CIN scheme on the cannabis market is that it is distinctly heterogeneous.

Aim: To compare characteristics of recreational vs. medical growers in a sample of small-scale cannabis cultivators from 12 countries. Methods: Six thousand eight hundred ninety six respondents who took part in an online survey were divided into three groups as: those who reported growing for recreational use, those cultivating for medical purposes who also reported use of other illegal drugs, and those who reported cultivation for medical use and didn't use other illegal substances. The groups were compared using multinomial logistic regression. Findings: In comparison to recreational growers, the two groups of medical growers included more females, consumed cannabis more frequently, and were more likely to cite health-related motivations for growing. The medical growers without other illicit drug use shared some of the same features with the medical growers with illicit drug use, but in comparison to both other groups, they were older, used less alcohol and tobacco, and were less likely to be involved in illicit activities other than drug crimes. Conclusions: Findings suggest that claims of medical use are not simply an attempt to justify personal cannabis consumption, but do at least partly reflect a genuine belief in medical benefit. However, those growing cannabis for medical reasons form a heterogeneous group of people. [ABSTRACT FROM AUTHOR]

Objective A wide range of synthetic cannabinoid products have recently become available through the Internet and shop fronts across the globe. Concerns about the consequences of their use have been prompted by increasing reports of emergency department presentations. Methods An anonymous global online survey was conducted using a research tool based on previous work carried out by the group. Data collection took place during a 4-week period at the end of 2011. Results Among 950 last-year users, 23 (2.4%) reported having sought emergency medical treatment following the use of a synthetic cannabinoid product. The most common presentations were panic and anxiety, followed by paranoia and breathing difficulties. Recent users who reported seeking emergency medical treatment were significantly younger (median age 20 years, interquartile range 18-22) than those who did not report seeking treatment (median age 23 years, interquartile range 19-28; Mann-Whitney test, z = 2.89, p = 0.004). Conclusions Synthetic cannabinoid use appears to be associated with a high prevalence of adverse experiences among users, especially younger users. Further research is required to determine whether particular compounds carry a higher risk of harm than others and to assess potential consequences of longer term use. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: The last decade has seen the appearance of myriad novel psychoactive substances with diverse effect profiles. Synthetic cannabinoids are among the most recently identified but least researched of these substances. Methods: An anonymous online survey was conducted in 2011 using a quantitative structured research tool. Missing data (median 2%) were treated by available-case analysis. Results: Of 14,966 participants, 2513 (17%) reported use of synthetic cannabis. Of these, 980 (41% of 2417) reported its use in the last 12 months. Almost all recent synthetic cannabis users (99% of 975) reported ever use of natural cannabis. Synthetic cannabis reportedly had both a shorter duration of action (2 = 17.82, p<.001) and quicker time to peak onset of effect (z = -9.44, p<.001) than natural cannabis. Natural cannabis was preferred to synthetic cannabis by 93% of users, with natural cannabis rated as having greater pleasurable effects when high (t(930) = -37.1, p<.001, d = -1.22) and being more able to function after use (t(884) = -13.3, p<.001, d = -0.45). Synthetic cannabis was associated with more negative effects (f(859) = 18.7, p<.001, d = 0.64), hangover effects (t(854) = 6.45, p<.001, d = 0.22) and greater paranoia (t(889) = 7.91. p < .001, d = 0.27). Conclusions: Users report a strong preference for natural over synthetic cannabis. The latter has a less desirable effect profile. Further research is required to determine longer term consequences of use and comparative dependence potential. [ABSTRACT FROM AUTHOR]

Introduction and Aims To assess the demographic profile, use patterns, market characteristics, reasons for first use and self-reported harms associated with use of synthetic cannabinoids in Australia. Design and Methods An online questionnaire was administered to a purposive sample of 316 Australian synthetic cannabinoid users [96% cannabis users, 77% male, median age 27 years, interquartile range ( IQR) 23-34] who self-reported demographic and drug use characteristics. Results The median duration of synthetic cannabinoid use was 6 months ( IQR 2-10), 35% reported use weekly or more often and 7% reported daily use. Reasons for first use included curiosity (50%), legality (39%), availability (23%), recreational effects (20%), therapeutic effects (9%), non-detection in standard drug screening assays (8%) and to aid the reduction or cessation of cannabis use (5%). Users reported buying a median of 3 g ( IQR 3-6) and paying a median of AU$60 ( IQR 37-90). Most (68%) reported at least one side-effect during their last session of use, including decreased motor co-ordination (39%), fast or irregular heartbeat (33%), dissociation (22%), dizziness (20%), paranoia (18%) and psychosis (4%). 4 respondents reported seeking help. A greater number of side-effects were reported by males, those aged 18-25 years, water pipe ('bong') users and concurrent alcohol drinkers. Discussion and Conclusions The sample reported first using synthetic cannabinoids due to curiosity, legality, availability, effects, non-detection in drug testing and to reduce their cannabis use. Harms were widely reported yet help-seeking was minimal. Inclusion of questions regarding synthetic cannabinoids in household surveys is warranted. [ABSTRACT FROM AUTHOR]

Despite various interventions available for substance use disorders, relapse rates remain substantial and, therefore, alternative strategies for attenuating dependence are needed. This study examined the associations between exercise frequency, illicit substance use, and dependence severity among a large sample of people who use drugs. The study utilized data from the Global Drug Survey 2018 (N = 57,110) to investigate the relationship between exercise frequency, illicit substance use, and substance dependence severity. Binomial regressions were employed to examine the relationship between exercise and SDS scores for 9 drugs. Greater exercise frequency correlated with reduced severity of substance dependence for specific drugs: cannabis (χ2 = 14.75, p < .001), MDMA (χ2 = 4.73, p = .029), cocaine (χ2 = 8.37, p = .015), amphetamine powder (χ2 = 6.39, p = .041), and methamphetamine (χ2 = 15.17, p < .001). These findings suggest a potential link between exercise and reduced substance use dependency. Further research is needed to understand the complex dynamics between exercise and substance use, considering potential bidirectional relationships and concurrent factors. [ABSTRACT FROM AUTHOR]