Recent use of synthetic cannabinoids, synthetic opioids and other psychoactive drug groups among high-risk drug users in Israel.
Background: Use of synthetic cannabinoids receptor agonists (SCRA) and synthetic opioids is associated with significant morbidity and mortality. These substances may be considered as substitutes or supplements to certain established drugs. We investigated associations between recent use, defined as 12-month prevalence of synthetic opioids and SCRA, and the recent use of cannabis, iv heroin, gabapentinoids, synthetic cathinones, stimulants, hallucinogens and benzodiazepines.
Methods: In this ongoing study, 342 high-risk drug-users attending physical detoxification and opioid maintenance treatment centers in Israel were interviewed to date. Mann Whitney-U test, Chi-Square test of independence and logistic regression analysis were used to identify and test correlates of recent SCRA and synthetic opioids use.
Results: Recent SCRA use was reported by 16.4% (n=56) of participants, and 25.4% (n=87) reported recent oral opioid and fentanyl use. 23 participants (6.7%) reported recent use of both synthetic opioids, fentanyl patches, and SCRA. After adjusting for age, and for age of onset of substance use, significant associations were identified between recent use of SCRA, and the recent use of cannabis (OR=10.3), and synthetic cathinones (OR=5.2). Among recent users of synthetic opioids and fentanyl, significant associations were identified with recent use of IV heroin (OR=5.6), gabapentinoids (OR=11.6), stimulants (OR=6.82), and benzodiazepines (OR=4.3).
Conclusions: Findings suggest that a large proportion of high-risk drug users in Israel, who use SCRA and/or synthetic opioids, are likely to concurrently abuse other specific drug groups. This confirms previous reports that SCRA and synthetic opioids complement, or even substitute other drug groups. Further examination is needed to uncover, and further explain prevalent patterns of substitution and supplementation of older established with novel psychoactive substances.