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In a groundbreaking study published by the Centers for Disease Control and Prevention (CDC), it's revealed that smoking has surpassed injecting as the dominant method of drug use in U.S. overdose fatalities. This comprehensive research, released recently, sheds light on shifting trends in drug consumption. The CDC's decision to delve into this topic was prompted by reports from California indicating a surge in smoking fentanyl instead of injecting it.
Lauren Tanz, the lead author of the study, highlights the potential benefits of smoking fentanyl over injecting it, indicating a possible reduction in injection-related overdose deaths. However, as a CDC scientist specializing in overdose research, Tanz underscores the substantial overdose risks associated with both methods. The impact of shifting towards smoking fentanyl on overall overdose fatalities in the United States remains uncertain.
Fentanyl, a potent illicit painkiller, is widely acknowledged as the main contributor to overdose deaths nationwide, despite its legitimate medical uses for severe pain management, including post-surgery or cancer-related pain. Its illicit distribution, often mixed with substances like heroin, poses serious risks to public health and safety. In recent years, illicit fentanyl has fueled the U.S. overdose crisis, resulting in a slight increase in overdose deaths in 2022 after significant surges during the pandemic. Provisional data for the first nine months of 2023 suggests a continued rise in overdose fatalities last year.
In recent years, the methods of consuming fentanyl have evolved significantly. While injection has historically been the primary route of administration, there has been a notable shift towards smoking fentanyl among drug users. According to Alex Kral, a researcher at RTI International specializing in drug use among communities in San Francisco, individuals now opt to place the powdered form of fentanyl on tin foil or in a glass pipe. By heating it from below, they produce vapor that is then inhaled.
According to Kral, smoked fentanyl may not be as concentrated as its syringe counterpart, but there are perceived advantages to this method among drug users. One significant benefit is the reduction of health risks associated with injection drug use. Those who inject drugs frequently face complications such as pus-filled abscesses on their skin and heightened vulnerability to infections like hepatitis and other diseases. The shift towards smoking fentanyl reflects a desire among users to mitigate these health risks while still achieving the desired effects of the drug.
This evolving trend presents new challenges for public health efforts targeting the fentanyl epidemic.
The CDC investigators utilized a comprehensive national database, comprising data from death certificates, toxicology reports, and input from coroners and medical examiners, to examine the trend. Their analysis covered the years 2020 to 2022 and included information gathered from the District of Columbia and 27 states. This extensive dataset shed light on drug consumption methods in over 71,000 cases out of the total 311,000 U.S. overdose deaths recorded during that timeframe, accounting for approximately 23% of the total.
Between early 2020 and late 2022, researchers identified a notable change in overdose death patterns. Smoking-related deaths surged by 74%, while deaths from injection declined by 29%. Additionally, there was an uptick in deaths associated with snorting, albeit less significant than smoking-related fatalities. Experts highlight the complexity of pinpointing exact percentages of deaths attributed to smoking, injecting, snorting, or swallowing drugs. This complexity arises from cases involving multiple drug use and varied methods of consumption, as well as instances where the specific drug-taking method remains unknown.
In late 2022, a comprehensive study revealed crucial insights into drug consumption methods leading to fatal overdoses. The findings showed that smoking accounted for 23% of deaths, followed by injections at 16%, snorting at 16%, and swallowing at 14.5%. Lead researcher Tanz emphasized the national significance of the data, collected from states across all regions. The report highlighted concerning trends of increasing smoking rates and decreasing injection rates nationwide. Smoking emerged as the dominant method in the West and Midwest, with a close competition with injection in the Northeast and South. These findings underscore the urgency for targeted interventions to address the escalating overdose crisis.
When it comes to understanding the causes behind an overdose death, especially in the absence of witnesses, it can be quite challenging. Injection-related fatalities are often more readily identifiable due to visible injection marks on the body.
Additionally, Kral highlighted that individuals who opt for smoking fentanyl frequently utilize a straw to inhale vapors from the ignited powder. This observation underscores the importance of meticulous investigation techniques to accurately determine the mode of drug consumption in overdose cases.