Skumlien Martine, Craft Sam, Russell Luke, Toshniwal Navyaa, Pudney Christopher, Freeman Tom P, Scott Jenny
Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK.
Department of Addictions, King's College London, London, UK.
Harm Reduct J. 2025 Jun 30;22(1):113. doi: 10.1186/s12954-025-01227-7.
Synthetic cannabinoids (SCs) are prevalent in prisons and among people who experience homelessness in the UK and can cause serious harms to people who use them. While it is currently not possible to test for SCs at the point of care (POC), a new method for doing so using fluorescence spectral fingerprinting has recently been developed. In this study, we aimed to outline the potential utility of POC SC testing in settings where SCs and SC use occur.
This is a mixed-methods study. Professional stakeholders (n = 449) working or volunteering in healthcare, homeless, police, or prison services were invited to give their views on POC SC testing in an online survey with both quantitative and qualitative (free text) questions. Follow-up interviews were conducted with 35 survey participants and additionally with 25 people who use synthetic cannabinoids (PWUSC). Quantitative survey responses on the overall view of saliva- or drug-based detection of SCs were compared between the four groups using Kruskal-Wallis tests. Qualitative survey responses were analysed using content analysis and interviews were analysed using thematic analysis.
SCs were perceived as prevalent in UK prisons and homeless communities, but stakeholders felt poorly equipped to tackle SC use and harms. The quantitative analyses revealed that all groups rated both saliva- and drug-based detection positively, but police and prison services were more positive towards both types of testing than healthcare and homeless services (all p's < 0.001). The thematic and content analyses outlined several potential benefits of POC SC testing across all four settings, with the strongest support for use in prisons, particularly to reduce the ingress of SCs. Both PWUSC and professional stakeholders raised concerns that testing would be used in a punitive manner and highlighted the lack of treatment options for SC dependence and overdose as a major barrier to reducing harms.
POC SC testing has the potential to support healthcare, homeless, police, and prison services in reducing the prevalence of SCs and improving the care of PWUSC. However, ethical application of the technology must be carefully considered to avoid causing undue harm to PWUSC, such as criminalisation and stigma.
合成大麻素（SCs）在英国的监狱中以及无家可归者中很普遍，会对使用者造成严重伤害。虽然目前无法在护理点（POC）对合成大麻素进行检测，但最近已开发出一种使用荧光光谱指纹识别技术进行检测的新方法。在本研究中，我们旨在概述在存在合成大麻素及其使用情况的环境中进行护理点合成大麻素检测的潜在效用。
这是一项混合方法研究。邀请了在医疗保健、无家可归者服务、警察或监狱服务领域工作或志愿服务的专业利益相关者（n = 449），通过一项包含定量和定性（自由文本）问题的在线调查，就护理点合成大麻素检测发表他们的看法。对35名调查参与者以及另外25名使用合成大麻素的人进行了后续访谈。使用Kruskal-Wallis检验比较了四组在基于唾液或药物检测合成大麻素的总体看法上的定量调查回复。使用内容分析法分析定性调查回复，使用主题分析法分析访谈内容。
合成大麻素在英国监狱和无家可归者社区中被认为很普遍，但利益相关者觉得应对合成大麻素使用及其危害的能力不足。定量分析显示，所有组对基于唾液和基于药物的检测评价都为正面，但警察和监狱服务部门对这两种检测方式的评价比医疗保健和无家可归者服务部门更为积极（所有p值<0.001）。主题和内容分析概述了在所有四种环境中进行护理点合成大麻素检测的几个潜在益处，其中对在监狱中使用的支持最为强烈，特别是为了减少合成大麻素的流入。使用合成大麻素的人和专业利益相关者都担心检测会被用于惩罚目的，并强调缺乏针对合成大麻素依赖和过量使用的治疗选择是减少危害的主要障碍。
护理点合成大麻素检测有潜力支持医疗保健、无家可归者服务、警察和监狱服务部门降低合成大麻素的流行率，并改善对使用合成大麻素者的护理。然而，必须仔细考虑该技术的道德应用，以避免对使用合成大麻素者造成不当伤害，如定罪和污名化。
