Spice (Synthetic Cannabis) use among the homeless in England: A Scoping Review

Abstract

Background: There  is  a  significant  area  of  concern  in  the  use  of  spice  among  the  homeless despite  the  enactment  of  the  Psychoactive  Substance  Act  (2016).  The increase in the number of people experiencing homelessness in England suggests that this drug problem will continue.  It is vital that we understand spice use among the homeless in order that appropriate support can be provided.  The  aim  of  this scoping  review  is  to  explore  the  use  of  Spice  (synthetic  cannabinoids)  among  the homeless people in England.

Methods: A  systematic  review  of  the  literature  published  in  England  from  2015  to  2019  was carried  out  in  August  2021  from  the  databases:  Cumulative  Index  to  Nursing  and Allied  Health  Literature  (CINAHL),  PubMed  (MEDLINE),  PSYCHINFO,  Web  of Science  and  Scopus,  in  order  to  identify  eligible  studies.  Studies  were  screened  by title  and  abstract,  followed  by  a  full  text  review.  Arksey  and  O’Malley’s  five  stage methodological  framework  for  scoping  reviews  was  followed.  Extracted data was charted, categorised, and summarised narratively.

Results: The scoping review process identified 13 studies for review.  The  data  extraction process  resulted  in  the  identification  of  four  themes:  the  characteristics  of  spice users;  motivating  factors  for  taking  the  drug;  evidenced  effects  of  taking  the  drugs among  the  homelessness;  and  policy/regulatory  challenges  of  tackling  the  drug problem.

Conclusions and recommendation: The review highlights that homelessness reflects deep-rooted structural inequalities of society.  The condition causes vulnerability which increases susceptibility to drug use. The study recommends addressing the homelessness problem in the first place as  a  health  protection  measure  that  could  deter  for  drug  use.  Beyond this, health prevention and health education, through tailoring service provision to this vulnerable group is necessary.