Fewer Synthetic Cannabinoid Poisonings in States with Legalized Medical Marijuana

PainRelief.com Interview with:
Tracy Klein, PhD, ARNP, FAANP, FRE, FAAN
Assistant Director, Center for Cannabis Policy, Research and Outreach
Associate Professor, College of Nursing
Washington State University Vancouver
Vancouver, WA

PainRelief.com: What is the background for this study?

Response: This study evaluates data on illicit synthetic cannabinoid poisonings reported to the National Poison Data System (NPDS) which contains data from 55 poison centers in the US (https://aapcc.org/about/our-members). We correlated the 7600 poisonings reported between 2016 and 2019 with the reporting state’s status of cannabis legalization: restrictive, medical and permissive.

PainRelief.com: What are the main findings?

Response: We found that state implementation of medical cannabis law was associated with 13%  fewer reported annual exposures. Adoption of permissive (recreational) state cannabis policy was independently and significantly associated with 37% lower reported annual synthetic exposures, relative to restrictive policies (IRR: 0.63, 95% CI: 0.50–0.79). 

PainRelief.com: What should readers take away from your report?

Response: Regulation of cannabis offers many opportunities for harm reduction, including labeling and packaging protections and testing for contaminants. This study also found that poisoning events from illicit synthetic cannabinoid products, which have no medical use, occur less frequently in states with access to regulated adult use cannabis. Because illicit cannabis causes harm and powerful side effects in addition to its psychoactive effects, consumers given a choice may choose less harmful intoxicants. There are also more opportunities for counseling and outreach in a regulated market. Most clinicians are unaware of these products, and they are not tested for in standard drug screens.

PainRelief.com: What recommendations do you have for future research as a result of this study?

Response: As a clinician, I would be interested in doing more research regarding if and how clinicians ask about use of these substances, and how aware they are of their effects. I think it would also be important, though difficult with illicit substances, to probe deeper into connecting with patients and finding out why and how they are using these drugs. I would also like to see more guidance for policymakers, who struggle with defining these drugs in regulation.

I have no disclosures related to this research. Dr. Liebelt, one of my co-authors, is the Associate Medical Director of the Arkansas Poison and Drug Information Center.  


Klein, T.A., et al. (2022) Synthetic Cannabinoid Poisonings and Access to the Legal Cannabis Market: Findings from US National Poison Center Data 2016-2019. Journal of Clinical Toxicology. doi.org/10.1080/15563650.2022.2099887.

The information on PainRelief.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

Last Updated on August 11, 2022 by PainRelief.com