Synthetic Cannabinoid Use and Sports‐Related Concussion Risk Among US Adolescents: Implications for School Health Screening and Prevention

BACKGROUND: Synthetic cannabinoids (SCs), such as Spice and K2, appeal to adolescents because they are inexpensive and often evade standard drug tests. We assessed associations between SC use and sports-related traumatic brain injuries (TBIs) among US adolescents. METHODS: We analyzed nationally representative Youth Risk Behavior Survey data from 2017-2021 (n = 27,482). Sports-related TBIs were defined as self-reported concussion in the past year. SC use was defined as lifetime use. Weighted multivariable logistic regression assessed the associations, adjusting for demographic and behavioral factors. RESULTS: Overall, 6.0% reported SC use, and 13% reported a sports-related TBI. TBI prevalence was higher among SC users (22.9%) than non-users (12.4%). SC use was associated with increased odds of a sports-related TBI (AOR 1.48, 95% CI 1.30-1.70). Other significant predictors included boys vs. girls (AOR 1.38, 95% CI 1.28-1.49), Black race vs. White (AOR 1.26, 95% CI 1.13-1.40), current alcohol use (AOR 1.75, 95% CI 1.61-1.91), marijuana use (AOR 1.16, 95% CI 1.05-1.28), depressive symptoms (AOR 1.21, 95% CI 1.11-1.32), and suicidal ideation (AOR 1.14, 95% CI 1.03-1.25). IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Incorporating SC-use screening into sports physicals and improving equitable access to concussion education may help reduce preventable injuries. CONCLUSIONS: SC use is associated with elevated sports-related concussion risk among adolescents.