J. DRUG EDUCATION, Vol.

43(3) 353-363, 2013

REASONS FOR SYNTHETIC THC USE AMONG

COLLEGE STUDENTS

REBECCA A. VIDOUREK, PH.D., CHES

KEITH A. KING, PH.D., MCHES

MICHELLE L. BURBAGE, B.A.

University of Cincinnati

ABSTRACT
Synthetic THC, also known as fake marijuana, is used by college students in
the United States. The present study examined reasons for recent synthetic
THC use among college students (N = 339). Students completed a 3-page sur-
vey during regularly scheduled class times. Results indicated students
reported using synthetic THC for curiosity, to get high, and the fun of feeling
high. No significant differences in reasons for use were found based on sex
and grade. College students reported most often obtaining synthetic THC
from head shops. Study findings may be beneficial to college health pro-
fessionals and others working with college students. High rates of lifetime use
may suggest that educational and intervention programs are needed.

INTRODUCTION
Synthetic THC, commonly known as spice, K2, or fake weed, is increasing in
popularity among college students. Current research demonstrates a steady rise in
synthetic THC intake (Coppola & Mondola, 2012). In fact, Hu, Primack, Barnett,
and Cook (2011) discovered that 1 in 10 college students used K2 in their lifetime.
In 2011, the Center for Substance Abuse Research (CESAR) found that 8% of
students in one study sample reported using synthetic THC in their lifetime
whereas additional research found 14% of undergraduate students used synthetic
THC (CESAR, 2013).

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On average, males are approximately twice as likely as females to use synthetic

THC (NIDA, 2012). In 2010, 77.5% of synthetic THC related ER visits involved
males, whereas 22.5% of the visits involved females (NIDA, 2013). Prevalence
rates are also higher among early college students as opposed to upper classmen
(Hu et al., 2011). Regarding age of initiation, many synthetic THC users first
initiate use while in high school (NIDA, 2012). CAESAR (2013) reported that the
average age of initiation for Synthetic THC use is approximately 18 years of age.
Recent research indicates that synthetic THC is the second most popular illegal
drug among high school seniors, with marijuana being the number one most
widely used illegal drug (NIDA, 2012).
Contrary to many other drugs, synthetic THC use is rapidly increasing among
young adults (Forrester & Haywood, 2012). Several reasons may have contributed
to increases in synthetic THC use, including ease of access and perceived safety.
Synthetic THC is readily available through various retail outlets. Synthetic THC
can be found at multiple venues including head shops (which are retail stores
specializing in tobacco products), convenient stores, gas stations, and the internet
(NIDA, 2012). Adding to this substance’s growing popularity, synthetic THC
yields similar effects like that produced by marijuana (Fattore & Fratta, 2011).
These psychoactive effects on individuals include relaxation, elevated mood, and
distorted perception (Hu et al., 2011; NIDA, 2012).
A comprehensive review of the literature revealed multiple negative side effects
of synthetic THC. Short-term effects include relaxation, elevated mood, distorted
perceptions of reality, and distortion of senses (Hu et al., 2011; NIDA, 2012). Many
psychological consequences are possible from synthetic THC and include paranoia,
hallucinations, and anxiety (NIDA, 2013). Physical side effects of synthetic THC
include rapid heart rate, high blood pressure, vomiting, confusion, muscle spasms,
seizures, and suicidal ideation (American Association of Poison Control Centers,
2012; Quan, Haase, and Levitan, 2011). Not surprisingly, in 2010 there were
approximately 12,000 visits to the ER due to synthetic THC (DAWN, 2012). More
than 75% of these visits were attributed to adolescents and young adults.
Unfortunately, young adults and adolescents often perceive synthetic THC as
harmless. This may be attributed to the fact that synthetic THC is typically labeled
as natural and safe (NIDA, 2012). In addition, distributors often claim Synthetic
THC is a harmless blend of herbs (Fattore & Fratta, 2011; NIDA, 2012).
Misleading labels fail to mention active synthetic compounds are present in the
product. Therefore, this deceptive marketing technique influences young adults’
perceptions of synthetic THC as a safe drug alternative.

Purpose of the Present Study

Limited research has been conducted which investigates synthetic THC use
among college students. In addition, there is a lack of existing literature regarding
specific reasons college students use synthetic THC. Therefore, this study seeks to
 SYNTHETIC THC USE / 355

fill these gaps by investigating the extent of Synthetic THC use among college
students, age of initiation, and specific reasons students use. Specifically, the
following research questions were examined:
1. What is the extent of recent (past 30 days) and lifetime synthetic THC use
among college students?
2. What is age of first use among college students?
3. What are reasons for using synthetic THC?
4. What are sources of synthetic THC?
5. What are common negative effects of synthetic THC?
6. Does age of initiation differ based on sex and grade?
7. Do reasons for use differ based on sex and grade?

METHODS

Participants
Students from a public university enrolled in Health, Physical Activity, and
Leisure classes were recruited as participants for this study. Participants were
notified that involvement in the study was voluntarily and all responses would be
kept anonymous and confidential. None of the students declined participation. All
students who were presented a survey elected to complete it.

Instrumentation
A 3-page survey, developed based on a comprehensive review of the literature,
was created to assess the research questions. A panel of experts (N = 5) in health
education, substance use, and survey research were provided the survey and asked
for suggestions in order to establish content validity. The panel’s recommen-
dations were considered by the research team and included in the final survey
instrument.
The survey consisted of several sections:
1. Extent of Synthetic THC Use;
2. Reasons for Synthetic THC Use;
3. Sources of Synthetic THC;
4. Side Effects of Synthetic THC; and
5. Demographics.
Extent of Synthetic THC Use included three items and assessed lifetime use,
recent use (past 30 days), and age of initiation. Students answered by filling in the
blank and checking the appropriate box. Reasons for Synthetic THC consisted of
11 items assessing potential reasons for use and requested students to answer
based on a 5-point scale (1 = Strongly Disagree; 5 = Strongly Agree). Sources of
THC included 12 items examining common locations for purchasing synthetic
356 / VIDOUREK, KING AND BURBAGE

THC and requested students to check all that apply. Side Effects of Synthetic THC
consisted of 12 items assessing potential negative health consequences experi-
enced from using synthetic THC and requested students to check all that apply. All
scales were developed based on a comprehensive review of the literature. Lastly,
demographics consisted of 10 items including sex, age, grade level, housing loca-
tion, etc., and requested students to check the appropriate box and fill in the blank.
In order to establish stability reliability of the survey, the survey was distributed
to a convenience sample of college students (N = 15). Students were administered
the survey on two different occasions 7 days apart. Kendall’s tau-b correlation
coefficients were calculated for nonparametric subscales and were greater than
>.80. Similarly, Pearson correlation coefficients were calculated for the para-
metric subscales and yielded coefficients >.85.

Procedures
Upon obtaining approval from the university institutional review board, a con-
venience sample of students enrolled in health, physical activity, and leisure
classes were administered surveys. All students were surveyed in their classrooms
during one academic semester. Students were enrolled in a variety of majors and
included a diverse sample of grade levels. No incentives were offered for
participation.
In the classroom, a research assistant trained on survey administration explained
the purpose of the study, ensured confidentiality and anonymity of responses, and
requested participation. All students were provided with a research information
sheet, which included the purpose of the study, contact information of the research
team, and additional information about the survey and study. All surveys were
collected by the research assistant, sealed in an envelope, and returned to the
primary investigator for data entry and analysis.

Data Analysis
SPSS statistical software package (Version 21.0) was used to perform data
analysis. Student background characteristics, perceptions of synthetic THC use,
and age of initiation were examined via frequency distributions, means, standard
deviations, and ranges. A series of Analysis of Variance (ANOVA) and Multi-
variate Analysis of Variance (MANOVA) were conducted to examine the research
questions. The alpha level of significance was set a priori at .05.

RESULTS

Demographic Characteristics
A total of 339 students at a major public university completed surveys (100%
response rate). Over half of the students were female (N = 200, 59.2%) as opposed
 SYNTHETIC THC USE / 357

to male (N = 138, 40.8%). Participant’s ages ranged from 18-36. Grade levels of
undergraduates varied within the sample that included 20.9% (freshman), 19.8%
(sophomore), 25.4% (junior), and 31.3% (senior). Graduate students (2.4%)
represented only a small portion of the study. Of the participants, 81% were white,
7.7% African American, 6% Asian, 3.3% self-reported as “other,” and 1.5%
Hispanic. The majority of the participants lived off campus (60.9%) as opposed to
those who lived on campus (22.1%), lived at home (15.2%), or listed “other”
(1.8%). Over half of the participants (57.8%) were involved in campus organi-
zations as opposed to not being involved (39.8%) in campus associations.

Extent of Synthetic THC Use

Of all students, 17.1% reported having ever used synthetic THC in their lifetime
whereas 3.0% reported recent use (past 30 days) of synthetic THC. The majority of
students (97.1%) reported having not recently used (past 30 days) Synthetic THC.
Of the students, 1.5 % reported using Synthetic THC the day before the survey was
distributed, .9% within the last 2 days, .3% within the last 15 days, and .3% within
the last 30 days.

Age of Initiation of Synthetic THC Use

Results found no significant differences in students’ use based on age of initi-
ation, F(1, 338) = .960, p = .331. However, results indicated that females had a
significantly younger average age of initiation (M = 17.81) than males (M = 18.42;
F(1, 338) = 4.509, p = .034). It was revealed that the average age in which fresh-
men and sophomores first used Synthetic THC was 16.85 years. Juniors, seniors,
and graduate students reported a later initiation age of 18.82 years. Significant
differences in students’ use was found based on grade level (F(1, 338) = 10.812,
p = .002). More specifically, freshmen and sophomores reported a significantly
earlier age of initiation than juniors, seniors, and graduate students.

Reasons for Synthetic THC Use

Results indicated that various reasons contributed to students’ use of Synthetic
THC (Table 1). It was revealed that the three major motivations included curiosity,
to get high, and the fun of feeling high. Curiosity (19.2%) regarding synthetic
THC was cited as the top reason for using the substance. With 17.4%, the second
highest reason for using the drug was for the purpose of getting high. Results also
indicated that 10.6% of students reported the fun of feeling high was a main factor
contributing to use.
Of the students who used Synthetic THC, social factors were the least likely to
influence their use of the product. Results revealed that 4.1% of the students felt
that they used these drugs to “fit in” whereas 3.8% used Synthetic THC due to peer
pressure. The results indicated that 2.7% of the students were unsure why they use
358 / VIDOUREK, KING AND BURBAGE

Synthetic THC. No significant differences of students’ use was found based on

reason for use in relation to sex (F(1, 338) = .602, p = .827; Table 2) and grade
level (F(1, 338) = .911, p = .530; Table 3).

Sources of Synthetic THC and Effects of Synthetic THC

The findings indicated that the students obtained Synthetic THC from a myriad
of locations. The majority of the students reported their source of Synthetic THC

Table 1. Reasons for Using Synthetic THC

Reason for Using Synthetic THC N (%)

Curious 65 (19.2)
Get High 59 (17.4)
Getting High is Fun 36 (10.6)
Friends were Using 34 (10.1)
Adventure 29 (8.5)
Relieve Stress 27 (8.0)
Did Not Think it Would Harm 22 (6.5)
Escape 18 (5.3)
Fit in 14 (4.1)
Peer Pressure 13 (3.8)
Do Not Know Why 9 (2.7)
Note: N = 339. Missing values excluded from analyses.

Table 2. Reasons for Using Synthetic THC Based on Sex

Males Females

Item M (SD) M (SD) F p

Get High 2.51 (1.330) 2.36 (1.318) 1.186 .277

Curious 2.59 (1.277) 2.39 (1.314) 1.974 .161
Adventure 2.28 (1.153) 2.17 (1.165) .769 .381
Getting High is Fun 2.39 (1.229) 2.22 (1.173) 1.774 .184
Fit in 2.04 (1.024) 1.95 (1.031) .675 .412
Friends were Using 2.26 (1.129) 2.14 (1.139) .926 .336
Escape 2.09 (1.104) 1.99 (1.063) .728 .394
Relieve Stress 2.27 (1.156) 2.08 (1.079) 2.466 .117
Peer Pressure 1.99 (1.057) 1.95 (1.043) .169 .681
Did Not Think it Would Harm 2.17 (1.057) 2.09 (1.099) .410 .523
Do Not Know Why 1.99 (1.029) 1.95 (1.036) .140 .709
Note: N = 339. Missing values excluded from analyses.
 SYNTHETIC THC USE / 359

Table 3. Reasons for Using Synthetic THC Based on Grade

Juniors/Seniors
Freshmen/ /Graduate
Item Sophomores Students

M (SD) M (SD) F p

Get High 2.24 (1.310) 2.55 (1.322) 4.405 .037

Curious 2.33 (1.297) 2.47 (1.298) 2.769 .097
Adventure 2.07 (1.163) 2.32 (1.150) 3.599 .059
Getting High is Fun 2.15 (1.196) 2.38 (1.193) 2.974 .086
Fit In 1.92 (1.068) 2.04 (.999) 1.017 .314
Friends were Using 2.05 (1.161) 2.29 (1.109) 3.507 .062
Escape 1.99 (1.120) 2.06 (1.052) .338 .562
Relieve Stress 2.07 (1.125) 2.21 (1.105) 1.246 .265
Peer Pressure 1.88 (1.043) 2.03 (1.049) 1.638 .201
Did Not Think it Would Harm 2.00 (1.081) 2.21 (1.076) 2.952 .087
Did Not Know Why 1.84 (.996) 2.05 (1.050) 3.156 .077
Note: N = 339. Missing values excluded from analyses.

was from head shops (7.4%). Friends (6.8%) and tobacco shops (6.2%) where also
reported as being main sources of Synthetic THC as opposed to hemp shops
(4.4%), Internet (3.8%), gas stations (3.8%), convenience stores (2.4%), and
“other” locales (.9%).
The results indicated that the students experienced several negative effects from
using Synthetic THC. The main effect reported from using this substance was
racing heartbeat (6.8%). Students also listed nervousness (5.6%), paranoia (5.0%),
nausea (5.0%), headaches (4.7%), and dilated pupils (3.5%) as negative effects
they suffered. The findings revealed fewer cases of hallucinations (2.1%), vomit-
ing (1.5%), high blood pressure (1.2%), “other” effects (1.2%), and tremors (.9%)
were experienced due to Synthetic THC use.

DISCUSSION
The present study found that 17% of students reported lifetime use of synthetic
THC and 3% of students reported recent use. Research studies indicate synthetic
THC is a popular drug of choice among high school students (NIDA, 2012). Per-
haps this research may explain the low rate of recent use among college students.
This finding may indicate that high school students are more likely to use synthetic
THC than college students. Studies focusing on high school use as well as reasons
why high school students report greater rates of recent use than college students
may be warranted. In addition, future studies should explore college students’
perceptions of synthetic THC use during the college years. Perhaps college
360 / VIDOUREK, KING AND BURBAGE

students perceive synthetic THC as a drug of choice for younger students thereby
decreasing use.
Results indicate that the average age of initiation is younger for females than
males. Females were found to first use this substance at 17.81 years of age as
opposed to males, who first use synthetic THC at 18.42 years of age. The mean age
of initiation is supported by past literature as the average age of first use is
typically 18 years of age, with many users being adolescents or young adults
(CAESAR, 2013; Hu et al., 2011; NIDA, 2012). However, previous research
found males are significantly more likely than females to report synthetic THC use
(CAESAR, 2013). Although not significant, the present study was comprised of
more females than males. This may explain study findings that females had an
earlier age of initiation than males. Future research with an equal number of males
and females may be necessary to explore sex differences in age of initiation.
Based on study findings, it appears senior year of high school and the first year
of college is the primary time for initiating use of synthetic THC. Perhaps, tar-
geting middle and high school students with educational programs on the negative
effects of synthetic THC is needed to prevent initiation and regular use. Previous
research indicates substance abuse prevention programs are effective for this age
group (Botvin, 2000; Froeschle, Smith, & Ricard, 2007). Additionally, programs
focusing on reducing positive attitudes towards drug use significantly reduced
substance use among middle and high school students (Froeschle et al., 2007;
Valentine, Griffith, Ruthazer, Gottlieb, & Keel, 1998). Prevention and educational
programs targeting this age group may be an effective strategy for decreasing
initiation of synthetic THC.
Underclassmen in this study were more likely than upperclassmen to initiate
use. This could be due to the rising trend of synthetic THC use in high schools
(NIDA, 2012). As use of synthetic THC is a recent trend, current underclassmen
may have initiated use while in high school. In the present study, freshmen and
sophomores were more likely to use than juniors and seniors. As use of synthetic
THC may begin during the high school years, this may explain the difference
between grade levels. Perhaps, first and second year college students used during
their high school years, possibly explaining this finding.
In the present study, students reported three primary reasons for using synthetic
THC. Curiosity was the number one reason for use followed by for the purpose of
getting high and pleasure from obtaining the high. Social factors such as peer
pressure were the least cited reasons for use. These findings are consistent with
previous research that also found curiosity and pleasure as the major reasons for
uses (Vandrey, Dunn, Fry, & Girling, 2012). Similarly, previous research found
social influences were not primary motivating factors to use synthetic THC. This is
contrary to many studies of substance abuse among youth which found social fac-
tors such as the peer group tend to influence overall use of substances including
alcohol, marijuana, and other illicit drugs (Duncan, Tildesley, Duncan, & Hops,
 SYNTHETIC THC USE / 361

1995; Jackson, 1997; Marcoux & Shope, 1997). Additional research is needed to
explore the role of social influences on synthetic THC use.
Regarding access, most students reported obtaining synthetic THC from head
shops. Friends and tobacco shops were also cited as common sources. Although
slightly less common, students also reported obtaining synthetic THC via hemp
shops, the internet, gas stations, and convenience stores. Previous research found
similar results, with specialty shops being primary purchase points for synthetic
THC (Fattore & Fratta, 2011; Forrester & Haywood, 2012). These findings should
be considered in prevention and intervention programs.
The negative health effects of synthetic THC use are commonly seen in U.S.
emergency rooms (Wiegand, 2012). In this study, students reported experiencing
multiple negative health effects from synthetic THC. Racing heartbeat was the
number one negative health effect reported. Students also cited nervousness, para-
noia, nausea, and headaches as adverse effects experienced while using. These
findings are consistent with previous research, which found headaches, nausea,
and paranoia as being negative symptoms of synthetic THC use (Fattore & Fratta,
2011; Vandrey et al., 2012). Implications from this finding should be noted. First,
research indicates that human consumption, safety, and toxicity data from syn-
thetic THC are lacking (Nichols, 2011). Studies should be conducted examining
these variables and determining baseline data for these drugs. In addition,
educational prevention programs should be implemented in order to raise aware-
ness of the negative health effects associated with synthetic THC consumption.
Presenting the potential negative consequences of synthetic THC may deter use
among some students. As many students perceive these drugs as safe, enhancing
perceived risk through prevention programs may be warranted.

Limitations

The following study limitations should be noted. The study sample consisted of
students from one Midwestern university. Therefore, caution should be exercised
in generalizing results to other populations. Next, monothematic nature of the
survey instrument may have resulted in a response set bias. Also, although stability
reliability of the survey was statistically strong, it should be noted that the sample
size for test-retest procedures was small (N = 15). Lastly, all data was self-reported
by participants. Socially desirable responses may have been reported by some
individuals.

CONCLUSIONS

The present study found high rates of lifetime use and low rates of recent use of
synthetic THC. This may indicate that students were more likely to use as high
school students rather than as current college students. Perhaps targeting high
362 / VIDOUREK, KING AND BURBAGE

school students with educational and prevention programs would decrease use of
synthetic THC. In addition, students reported negative side effects of using
synthetic THC. Educational programs educating students about the negative
health effects of synthetic THC are warranted to reduce use.

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Direct reprint requests to:

Dr. Rebecca A. Vidourek
Assistant Professor Health Promotion and Education Program
University of Cincinnati
PO Box 210068, ML 0068, 526 TC
Cincinnati, OH 45221-0068
e-mail: rebecca.vidourek@uc.edu
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