United States drug prohibition and legal highs: How drug testing may lead cannabis users to Spice

Aims: At the time of the study, the synthetic cannabinoid K2/K3, which is sold as 'Spice' incense, was legal in many states in the US. Because the US Drug Enforcement Agency has emergency scheduled 'Spice', the producers of these synthetic substances have altered their chemical compounds to remain legal and on the market. This study seeks to understand the reasons for use of these substances and the role US drug policy plays in encouraging use. Methods: Employed a mixed-methods approach. We surveyed 374 undergraduate students in a Southern California University and conducted 25 qualitative interviews of users who answered a newspaper or flyer advertisement of the study. Findings: Most of the users in the qualitative sample sought a legal alternative to cannabis (their drug of choice) to avoid positive drug test screenings and criminal sanctions. Many were attending abstinence-only drug treatment programmes, under community corrections, or were seeking a career in the US military. These individuals were randomly drug tested and knew that the metabolites of synthetic cannabis are not detected in standard urine drug screenings. Conclusions: US drug policies - the prohibition of marijuana and the proliferation of drug testing - have led users to seek out legal highs.