The lifetime use of alcohol, cigarettes, and other illicit drugs increases the odds of using synthetic marijuana, Joseph J. Palamar, Ph.D., and Patricia Acosta found in a study of U.S. high school seniors. However, the strongest correlate of more frequent use of the substance is frequency of lifetime natural marijuana use. Only 0.5% of non–marijuana smokers reported use of synthetic marijuana, Dr. Palamar and Ms. Acosta wrote.

While 10% of the high school seniors studied reported using synthetic marijuana at least once recently, only 3% reported repeated (≥ six times) use. Female, black, and religious students were at low risk for use, unless controlled for other drug use. Higher income, use of alcohol and other drugs, and going out 4-7 nights a week all increased the odds of use.

Students who already use illicit drugs might use synthetic marijuana as a “safe” alternative, but “there is no evidence suggesting use of novel psychoactive drugs such as synthetic cannabinoids serve as a ‘gateway’ to other illicit drugs,” the investigators said. However, they said, any use of synthetic marijuana “may still place users at risk of adverse effects.” Find the full study in Drug and Alcohol Dependence (doi:10.1016/j.drugalcdep.2015.01.044).

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