Prevalence and Correlates of Synthetic Cannabinoid Use in a Substance Use Treatment Population: An Electronic Health Record Study in Brazil

BACKGROUND: Synthetic cannabinoids (SCs) are the fastest-growing class of novel psychoactive substances in Brazil, yet epidemiological data on their prevalence and correlates remain limited. This study examined differences in sociodemographic, treatment, and clinical characteristics between individuals in substance use treatment who reported SCs use and those who did not, and identified factors associated with SCs use frequency. METHODS: = 6,660). RESULTS: A total of 1943 service users (29.17%) self-reported using SCs in the past 12 months. Of these, 28.9% initiated use before age 21, 51.7% reported polysubstance use (cocaine, crack-cocaine, and cannabis) before initiating SCs use, and 63.4% reported daily use. Compared with non-users, SC users were more likely to be younger, to have attended another treatment service in the past 12 months, and to have frequented open drug scenes (ODS). They also reported greater use of cocaine, crack-cocaine, cannabis, solvents, and methamphetamines, higher rates of polydrug use, more severe cocaine/crack addiction scores, and more frequent high or severe psychotic symptoms. Similar factors were associated with the frequency of SCs use. CONCLUSION: The findings reveal a mixed profile of SCs users comprising individuals from ODS and younger users from other areas. It highlights the need for adaptive public health policies, enhanced surveillance, and tailored treatment approaches to address the evolving complexity of Brazil's drug landscape.