A significant shift in drug consumption patterns in the United States is emerging as users increasingly prefer smoking over injecting opioids, particularly fentanyl. This change, which has gained momentum since the Covid-19 pandemic, is impacting harm reduction strategies across the country.
Changing Patterns of Drug Use
In Rochester, New Hampshire, harm reduction worker Megan Merrill is at the forefront of this transformation. While distributing supplies aimed at helping vulnerable drug users, she emphasizes the benefits of smoking over injecting. Merrill’s backpack is loaded with essential items such as sterile syringes, condoms, and emergency blankets, but her primary focus is on distributing glass pipes.
“Injection can lead to infections, diseases, skin abscesses, and potentially higher rates of fatal overdose,” Merrill explains. “You’re going to see less vein damage, and there’s less chance of you overdosing if you’re smoking than if you’re injecting.” This perspective highlights a growing consensus among harm reduction advocates that smoking provides a safer alternative to injection, particularly in light of the risks associated with substances like fentanyl and xylazine, a potent animal tranquilizer.
The trend towards smoking has become evident across various U.S. cities, with a notable rise in areas heavily impacted by the opioid crisis. Once predominantly observed on the West Coast, this shift is now spreading eastward, especially in cities like Philadelphia. The increasing toxicity of street drugs has prompted many users to avoid syringes altogether, leading harm reduction organizations to adapt their services accordingly.
Health Benefits and Public Response
Experts suggest that the shift from injection to smoking could contribute to a decline in overdose deaths. According to research, individuals who smoke drugs may be as much as 30% less likely to experience an overdose compared to those who inject. Additionally, smoking can reduce the transmission of blood-borne illnesses such as HIV and hepatitis C, which are more prevalent among injection drug users.
Despite the positive developments, public perception and policy surrounding harm reduction remain contentious. The Biden administration’s support for the distribution of “safer smoking kits” faced significant backlash, particularly from conservative circles. Nonetheless, organizations like Smoke Works, which began as a syringe exchange program, have seen increasing demand for smoking supplies.
Executive Director Jim Duffy noted that many participants in their programs were more interested in obtaining pipes than syringes. “Not everybody wanted to inject,” he remarked, highlighting a shift in user preferences that may not align with existing public health strategies.
As the opioid crisis continues to evolve, the importance of harm reduction strategies that prioritize user health cannot be overstated. With more than 45,000 opioid overdose deaths reported in the U.S. each year, the potential benefits of encouraging safer methods of consumption are clear. Harm reduction advocates like Merrill are committed to meeting the needs of users, emphasizing that “we call it safer because you’re not always going to be 100% safe in everything you do, but we can make it safer.”
The ongoing transition from injection to smoking underscores the need for public health officials to engage with the realities faced by drug users. As the landscape of the opioid epidemic continues to shift, adapting harm reduction strategies to prioritize smoking may offer a pathway to reducing the health risks associated with drug use.
Ultimately, the efforts of individuals like Merrill and organizations committed to harm reduction represent a crucial aspect of addressing the complex challenges posed by drug addiction in the United States.
