As illicit drug trafficking becomes more widespread, it is increasingly important to assess the extent of drug abuse for health and safety reasons. However, on the one hand, administering questionnaires to consumers is time-consuming and inconclusive, and on the other hand, seizures and clinical data evaluate service performance in response to the flow of illicit drugs rather than the flow itself. Wastewater-based epidemiology has ushered in a new era, but it tends to provide snapshots and encourages the bias of assuming that recalculated consumption is stable between samples. In Mayotte, synthetic cannabinoid receptor agonists (SCRAs), the main constituents of "chimique," have achieved an unusual status as an iconic hard drug in a disorganized political context. Assuming a "worst-case scenario," i.e., insularity and the specificity of SCRAs drug abuse in Mayotte, this approach aimed to explore the evolution of the nature and concentration of SCRAs, as well as their location. Over the course of a year, eight "chimique" sampling campaigns were conducted in Mayotte, collecting samples from street users and in places of open consumption for 1 week each. Consumers were offered (i) an interview (standard of living, sources of supply, consumption, co-addictions, side effects on health, and social life) and (ii) the opportunity to provide a sample of their "chimique" dose for analysis and to be informed of its composition. The collected "chimique" samples were analyzed using a liquid chromatography method with high-resolution mass spectrometry detection method and (i) "in-house" and (ii) online (HighResNPS) spectral libraries. Illegal drugs were identified during each campaign, for a total of 195 samples (187 cigarettes and 8 powders). Thirteen different SCRAs were observed in association with a plant matrix (tobacco was predominant, mixed or unmixed with cannabis). Co-formulants included cannabinoids, pharmaceuticals/precursors, and/or other new psychoactive substances. The results showed that month after month, the market became more homogeneous due to the products offered by SCRA pharmaceutical manufacturers and the growing hegemony of a gang of traffickers. However, the profile of the samples collected changed rapidly, sometimes becoming unrecognizable from one campaign to the next.
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