Introduction: Cannabis is the most widely used illicit drug in Europe. In recent years novel synthetic cannabinoids, more potent than cannabis, have emerged. Novel psychoactive substances were banned in the UK upon implementation of the 2016 Psychoactive Substances Act (PSA). Despite this legislation, synthetic cannabinoids continue to be increasingly used as drugs of abuse, with small doses posing serious health risks and ultimate death to users.

Methods: All deaths in England and Northern Ireland reported to the National Programme on Substance Abuse Deaths (NPSAD) database with synthetic cannabinoids found at post-mortem toxicology and/or implicated in death were extracted and analysed using IBM(R) SPSS Statistics.

Findings: A total of 123 synthetic cannabinoid-related deaths were reported to NPSAD from 2012-2018. A drastic increase in deaths within this time period is evident: two deaths were recorded in 2012, withy 46 deaths in 2017, and 47 deaths in 2018 (projected). Death was deemed unintentional in 95.1% of cases (n=117/123), with the synthetic cannabinoid determined as directly contributing to the death in 87.2% of these cases. By comparison, cannabis was directly implicated in 5.7% of deaths within the same cohort. Unemployed males of no fixed abode or living in sheltered accommodation were particularly susceptible to synthetic cannabinoid-related deaths.

Conclusions: The drastic increase in synthetic cannabinoid-related deaths is of great concern, with the peak incident rate post-PSA signifying that additional alternate policy strategies to prevent such deaths are required. These data have been reported to the Home Office’s independent Advisory Council for the Misuse of Drugs.

Poster link: Not the spice of life: synthetic cannabinoid deaths in England and Northern Ireland (2012-2018)