title: Synthetic cannabinoid withdrawal: a new demand on detoxification services.
abstract: OBJECTIVE
  Synthetic cannabinoid dependence and withdrawal are not well described in the literature. We aimed to report on the characteristics and treatment course of clients attending a detoxification service for support with synthetic cannabinoid withdrawal in Auckland, New Zealand.
  
  
  METHODS
  A retrospective audit of electronic and paper files for clients presenting for treatment in association with problematic synthetic cannabinoid use between May 2013 and May 2014 was conducted. Demographic information, reported synthetic cannabinoid use, other substance use, reported adverse effects, withdrawal symptoms and treatment information were recorded using a piloted template. Descriptive statistics were used to summarise the characteristics of the audit sample.
  
  
  RESULTS
  In the 12 month period, 47 people presented to detoxification services reporting problems withdrawing from synthetic cannabinoids. Twenty clients were admitted for medical management within an inpatient setting. Coexisting substance dependence apart from nicotine dependence was low. The most common withdrawal symptoms were agitation, irritability, anxiety and mood swings. Withdrawal symptoms were managed with diazepam and quetiapine.
  
  
  CONCLUSIONS
  The harm associated with use of synthetic cannabinoids has had a direct impact on the utilisation of specialist alcohol and drug services in Auckland, New Zealand. Many clients with synthetic cannabinoid withdrawal symptoms required intensive support including medication and admission to an inpatient detoxification unit. Clients withdrawing from synthetic cannabinoids were the third largest group of clients admitted to inpatient detoxification services in Auckland, New Zealand, between May 2013 and May 2014.
authors.affiliation: Medical Detoxifications Services, Community Alcohol and Drug Services, Waitemata District Health Board, Auckland, New Zealand.
authors.forename: Vicki
authors.initials: V
authors.lastname: Macfarlane
authors.forename: Grant
authors.initials: G
authors.lastname: Christie
mesh_terms: D000293:Adolescent; D000328:Adult; D002186:Cannabinoids / Q000009:adverse effects*; D005260:Female; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D012189:Retrospective Studies; D016320:Substance Abuse Treatment Centers / Q000639:trends*; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D055815:Young Adult
chemical_list: D002186:Cannabinoids
keywords: cannabis; harm reduction; substance related disorder; substance withdrawal syndrome; synthetic cannabinoid