Patterns, harms and responses to licit and illicit substance use in Zimbabwe: A scoping review

Anecdotal reports highlight increased methamphetamine, cocaine, and codeine-cough syrup use in Zimbabwe, with no clear empirical basis. Therefore, the scoping review aimed to identify primary evidence of patterns, harms and responses to substance use (SU) within Zimbabwe. Arksey and O'Malley's (2005) framework and the PRISMA Extension for Scoping Reviews (Tricco et al., 2018) were followed. Medline (Pub Med), Scopus, Academic Search Premier, Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus), African Index Medicus, Africa-Wide Information, Web of Science, PsycInfo, PsycArticles, and Web of Science conference proceedings were searched. 27 studies published between 2012, and February 2025 met the inclusion criteria and were synthesized using combined inductive-deductive thematic analysis. Patterns of SU included a wide range of drugs (e.g. alcohol, tobacco, cannabis, inhalants, codeine-cough syrups), with emergent literature on methamphetamine, cocaine and heroin. Socio-demographic patterns elucidated vulnerable groups (e.g. children living on the streets), and concentration of SU in high density urban areas. SU harms predominantly centered on the link to the HIV epidemic, whilst clinical and health responses to SU were significantly limited. SU should therefore be treated as a public health priority in Zimbabwe, and research capacity building is urgently required to address significant literature gaps.