{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T08:53:28Z","timestamp":1788252808635,"version":"build-2803163510"},"reference-count":67,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cannabis &amp; Cannabinoid Research"],"published-print":{"date-parts":[[2022,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To identify drug-related death trends associated with synthetic cannabinoid receptor agonists (SCRAs) reported to the National Programme on Substance Abuse Deaths (NPSAD) from England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Case reports from NPSAD (England) where a SCRA was detected in post-mortem tissue(s) and\/or implicated in the death were extracted, analyzed, and compared against non-SCRA-related deaths that occurred over the same time period (2012\u20132019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings:<\/jats:title>\n                    <jats:p>One hundred sixty-five death SCRA-related reports were extracted, with 18 different SCRAs detected. Following the first death in 2012, a subsequent sharp increase in reporting is evident. Acute SCRA use was the underlying cause of death in the majority of cases (75.8%) with cardiorespiratory complications the most frequently cited underlying physiological cause (13.4%). SCRA users were predominantly found dead (68.6%), with a large proportion of those witnessed becoming unresponsive described as suddenly collapsing (81.6%). Psychoactive polydrug use was detected in 90.3% of cases, with alcohol the most commonly co-detected (50.3%), followed by opioids (42.2%), benzodiazepines\/Z-drugs (32.1%), stimulants (32.1%, [28.5% cocaine]), and cannabis (24.8%).<\/jats:p>\n                    <jats:p>\n                      Compared to all non-SCRA-related NPSAD deaths occurring over the same time period, SCRA-related decedents were more predominantly male (90.3% vs. 72.0%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.01), and lived in more deprived areas (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.01). While a comparatively significant proportion of decedents were homeless (19.4% vs. 4.1%), living in a hostel (13.3% vs. 2.3%) or in prison (4.9% vs. 0.2%) at time of death (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.01), the greatest majority of SCRA-related decedents were living in private residential accommodations (57.6%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This is the largest dataset regarding SCRA-related mortalities reported to date. Reporting of SCRA-related deaths in England have increased considerably, with polydrug use a specific concern. Lack of effective deterrents to SCRA use under current UK legislation, compounded by limited knowledge regarding the physiological impacts of SCRA consumption and their interaction with other co-administered substances are contributory factors to the occurrence of SCRA-related mortalities in an increasingly deprived demographic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/can.2020.0161","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T11:41:10Z","timestamp":1614339670000},"page":"516-525","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":37,"title":["Synthetic Cannabinoid-Related Deaths in England, 2012\u20132019"],"prefix":"10.1177","volume":"7","author":[{"given":"Pruntha","family":"Yoganathan","sequence":"first","affiliation":[{"name":"Population Health Research Institute, St George's, University of London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugh","family":"Claridge","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, St George's, University of London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Chester","sequence":"additional","affiliation":[{"name":"Department of Psychosis Studies and Institute of Psychiatry, Psychology &amp; Neuroscience, King's College London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Englund","sequence":"additional","affiliation":[{"name":"Department of Addictions, Institute of Psychiatry, Psychology &amp; Neuroscience, King's College London, London, United Kingdom."},{"name":"South London and Maudsley NHS Foundation Trust, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola J.","family":"Kalk","sequence":"additional","affiliation":[{"name":"Department of Addictions, Institute of Psychiatry, Psychology &amp; Neuroscience, King's College London, London, United Kingdom."},{"name":"South London and Maudsley NHS Foundation Trust, London, United Kingdom."},{"name":"KCH Alcohol Care Team, South London and Maudsley NHS Foundation Trust, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline S.","family":"Copeland","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, St George's, University of London, London, United Kingdom."},{"name":"Institute of Pharmaceutical Science, King's College London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,8,9]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269881119826592"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2011.01.066"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00002.2016"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.827"},{"key":"e_1_3_4_6_2","unstructured":"European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). 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