This study aims to explore polysubstance practices among vulnerable homeless people who use synthetic cannabinoid receptor agonists (SCRAs) in a deprived rural county (second lowest per capita gross domestic product in England). SCRA use is prevalent among homeless populations, and the use of SCRAs with other drugs poses a potential risk to public health. Understanding patterns of polysubstance use and motivations for use can help to better understand where policy may be implemented to prevent harms.
This research is based on 21 qualitative interviews with 11 users of SCRAs and 10 frontline practitioners working with those who use SCRAs. A life story approach to interviewing was adopted for users of SCRAs, with data from all interviews analysed thematically.
Polysubstance use was prevalent in the sample. Participants identified motivations including substituting SCRAs for heroin or alcohol in broader drug-using routines; Uncertainty in the local NPS market with many drugs sold as “Spice”; self-medicating for trauma and the pains of everyday life on the street; and managing withdrawals from other drugs through SCRA use. Our practitioners suggested a personal approach to dealing with vulnerable users of drugs was needed, with stigma presenting a significant challenge to public health.
This study was based on original research conducted by the first author. It makes original contribution to understanding of polysubstance use with SCRAs in deprived rural locales, and implications for public health policy.
