More deaths after smoking than injecting drugs | Inquirer News

More people die after smoking drugs than injecting them – US study

/ 12:25 PM February 16, 2024
PHOTO: A man prepares to smoke fentanyl on a park bench in downtown Portland, Oregon, on Thursday, May 18, 2023. STORY: More people die after smoking drugs than injecting them – US study
A man prepares to smoke fentanyl on a park bench in downtown Portland, Oregon, on Thursday, May 18, 2023. (File photo by BETH NAKAMURA / The Oregonian via Associated Press)

NEW YORK — Smoking has surpassed injecting as the most common way of taking drugs in US overdose deaths, a new government study suggests.

The Centers for Disease Control and Prevention called its study published Thursday the largest to look at how Americans took the drugs that killed them.

CDC officials decided to study the topic after seeing reports from California suggesting that smoking fentanyl was becoming more common than injecting it. Potent, illicit versions of the painkiller are involved in more US overdose deaths than any other drug.


READ: UP study: Young Filipinos turning away from smoking, drinking


READ: Dependents turned advocates aim to change drugs narrative

READ: Political will key to drug policy change in PH, advocates say

Some early research has suggested that smoking fentanyl is somewhat less deadly than injecting it, and any reduction in injection-related overdose deaths is a positive, said the study’s lead author, Lauren Tanz.

But “both injection and smoking carry a substantial overdose risk,” and it’s not yet clear if a shift toward smoking fentanyl reduces US overdose deaths, said Tanz, a CDC scientist who studies overdoses.

Illicit fentanyl is an infamously powerful drug that, in powder form, increasingly has been cut into heroin or other drugs. In recent years, it’s been a primary driver of the US overdose epidemic. Drug overdose deaths in the US went up slightly in 2022 after two giant leaps during the pandemic, and provisional data for the first nine months of 2023 suggests it inched up last year.

For years, fentanyl has mainly been injected, but drug users have increasingly smoked it. People put the powder on tin foil or in a glass pipe, heated from below, and inhale the vapor, explained Alex Kral, an RTI International researcher who studies drug users in San Francisco.


Smoked fentanyl is not as concentrated as fentanyl in a syringe, but some drug-takers see upsides to smoking, Kral said. Among them: People who inject often deal with pus-filled abscesses on their skin and risk infections with hepatitis and other diseases.

“One person showed me his arms and said, ‘Hey, look at my arm! It looks beautiful! I can now wear T-shirts and I can get a job because I don’t have these track marks,'” Kral said.

CDC investigators studied the trend by using a national database built from death certificates, toxicology reports, and reports from coroners and medical examiners.

They got suitable data from the District of Columbia and 27 states for the years 2020 to 2022. From those places, they got information on how drugs were taken in about 71,000 of the more than 311,000 total US overdose deaths over those three years — or about 23%.

The researchers found that between early 2020 and late 2022, the percentage of overdose deaths with evidence of smoking rose by 74%, while the percentage of deaths with evidence of injection fell by 29%. The number and percentage of deaths with evidence of snorting also increased, though not as dramatically as smoking-related deaths, the study found.

It’s complicated to map out the exact percentages of deaths that occurred after smoking, injecting, snorting, or swallowing drugs, experts say. In some cases, a person may have used multiple drugs in different ways. In other cases, no drug-taking method was identified.

The study found that in late 2022, of the deaths for which a method was identified, 23% of the deaths occurred after smoking, 16% after injections, 16% after snorting, and 14.5% after swallowing.

Tanz said she feels the data is nationally representative. Data came from states from every region of the country, and all showed increases in smoking and decreases in injecting. Smoking was the most common route in the West and Midwest and roughly tied with injecting in the Northeast and South, the report said.

Kral described the study as “mostly good” but said it has limitations.

It can be challenging to ascertain the how and why of an overdose death, especially if no witness was present. Injections might be more commonly reported because of injection marks on the body; to detect smoking, “they likely would need to find a pipe or foil on the scene and decide whether to write that down,” he said.

Your subscription could not be saved. Please try again.
Your subscription has been successful.

Subscribe to our daily newsletter

By providing an email address. I agree to the Terms of Use and acknowledge that I have read the Privacy Policy.

Kral also noted that many people who smoke fentanyl use a straw to inhale vapors from the burning powder, and it’s possible investigators saw a straw and assumed it was snorted.

TAGS: Centers for Disease Control and Prevention, drug overdose, illegal drug use

© Copyright 1997-2024 | All Rights Reserved

We use cookies to ensure you get the best experience on our website. By continuing, you are agreeing to our use of cookies. To find out more, please click this link.