The use of synthetic cannabinoid receptor agonists (SCRAs) within the homeless population: motivations, harms and the implications for developing an appropriate response

Abstract

Background: Synthetic cannabinoid receptor agonists (SCRAs) have become increasingly associated with a range of physical, mental health and societal harms. In response, several countries have introduced legislation aimed at restricting their supply and use. While these legislative changes have led to a decrease in SCRA use within the general population, SCRAs remain popular within vulnerable populations, in particular the homeless. This article presents the findings from the first in-depth qualitative study of SCRA use within the homeless population. It makes an important and timely contribution to the current evidence base and discourse on how governments and service providers should respond to SCRA use within the homeless population. Methods: The research on which this article is based was undertaken in Manchester, UK. Qualitative interviews were undertaken with 53 homeless users of SCRAs and 31 stakeholders. Results: The motivations for SCRA use are broadly similar to those associated with traditional drugs; namely to escape from the reality of life on the streets, and to provide relief from the physical conditions of a street-based lifestyle. However, the combination of their low cost, the ease with which they can be accessed, their high potency, and their non-detectability explains their particular appeal to the homeless population. Alongside these motivations, the research identified a range of physical, mental health, and societal harms that were directly attributable to SCRAs. Conclusions: The most appropriate way to address the continued use of SCRAs within the homeless population is through the development of a more appropriate service response rather than further legislative change.