The utility of a new point-of-care test for synthetic cannabinoids: a mixed-methods study in people who use synthetic cannabinoids and stakeholders

Abstract Background 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 fluoresc...

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Main Authors: Martine Skumlien, Sam Craft, Luke Russell, Navyaa Toshniwal, Christopher Pudney, Tom P. Freeman, Jenny Scott
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Harm Reduction Journal
Subjects:
Online Access:https://doi.org/10.1186/s12954-025-01227-7
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author Martine Skumlien
Sam Craft
Luke Russell
Navyaa Toshniwal
Christopher Pudney
Tom P. Freeman
Jenny Scott
author_facet Martine Skumlien
Sam Craft
Luke Russell
Navyaa Toshniwal
Christopher Pudney
Tom P. Freeman
Jenny Scott
author_sort Martine Skumlien
collection DOAJ
description Abstract Background 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. Methods 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. Results 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. Conclusions 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.
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spelling doaj-art-ddd1d6022f7a420b9f87b9f172e5de4e2025-08-20T03:37:23ZengBMCHarm Reduction Journal1477-75172025-06-0122111310.1186/s12954-025-01227-7The utility of a new point-of-care test for synthetic cannabinoids: a mixed-methods study in people who use synthetic cannabinoids and stakeholdersMartine Skumlien0Sam Craft1Luke Russell2Navyaa Toshniwal3Christopher Pudney4Tom P. Freeman5Jenny Scott6Addiction and Mental Health Group (AIM), Department of Psychology, University of BathAddiction and Mental Health Group (AIM), Department of Psychology, University of BathAddiction and Mental Health Group (AIM), Department of Psychology, University of BathAddiction and Mental Health Group (AIM), Department of Psychology, University of BathDepartment of Life Sciences, University of BathAddiction and Mental Health Group (AIM), Department of Psychology, University of BathCentre for Academic Primary Care, Bristol Medical School, University of BristolAbstract Background 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. Methods 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. Results 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. Conclusions 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.https://doi.org/10.1186/s12954-025-01227-7Synthetic cannabinoidsSpiceDrug testingDrug checkingHomelessnessPoint of care technology
spellingShingle Martine Skumlien
Sam Craft
Luke Russell
Navyaa Toshniwal
Christopher Pudney
Tom P. Freeman
Jenny Scott
The utility of a new point-of-care test for synthetic cannabinoids: a mixed-methods study in people who use synthetic cannabinoids and stakeholders
Harm Reduction Journal
Synthetic cannabinoids
Spice
Drug testing
Drug checking
Homelessness
Point of care technology
title The utility of a new point-of-care test for synthetic cannabinoids: a mixed-methods study in people who use synthetic cannabinoids and stakeholders
title_full The utility of a new point-of-care test for synthetic cannabinoids: a mixed-methods study in people who use synthetic cannabinoids and stakeholders
title_fullStr The utility of a new point-of-care test for synthetic cannabinoids: a mixed-methods study in people who use synthetic cannabinoids and stakeholders
title_full_unstemmed The utility of a new point-of-care test for synthetic cannabinoids: a mixed-methods study in people who use synthetic cannabinoids and stakeholders
title_short The utility of a new point-of-care test for synthetic cannabinoids: a mixed-methods study in people who use synthetic cannabinoids and stakeholders
title_sort utility of a new point of care test for synthetic cannabinoids a mixed methods study in people who use synthetic cannabinoids and stakeholders
topic Synthetic cannabinoids
Spice
Drug testing
Drug checking
Homelessness
Point of care technology
url https://doi.org/10.1186/s12954-025-01227-7
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