Smoking is a Safer Mode of Drug Administration

What You Need To Know

• Fentanyl, especially in its pill form, is most often smoked rather than injected, both by individuals who are new to opioid use and by those experienced in injecting black tar heroin. Along with a parallel increase in the use of methamphetamine, which is also commonly smoked, the prevalence of opioid and stimulant smoking is quickly overtaking injection as a primary and frequent route of administration.

• Drug smoking supplies distributed by harm reduction programs typically include: glass stems and pipes used to inhale smoke or vapors, plastic mouth pieces to prevent lip burns, and items to insert or hold the drug in place such as screens, wire, and wooden push sticks. Some drugs are smoked directly from pieces of foil. Many programs also distribute alcohol wipes to clean hands and pipes and lip balm to prevent cracking; both items reduce the risk of HIV and hepatitis C.

• Smoking supplies distributed by harm reduction programs are clean and safer than improvised items like aluminum cans, plastic tubes, steel wool, and light bulbs that can break easily or release toxic fumes.

• Individuals may choose to smoke drugs (rather than inject or snort) because they:

  • prefer the particular “high” from smoking (injecting and smoking can create different effects).

  • want to avoid the greater health risks from injecting.

  • can no longer inject drugs due to extensive vein damage.

• Source

Where to Go for More Information

• Next Distro

• Bevel Up

• Tweaker.org

• Smoking From Foil

• North Carolina Harm Reduction: Safer Crack Use

• CATIE: How to Smoke Drugs (videos)

Programs To Know

• Smoke Works : advances health equity in harm reduction by making injection alternatives accessible at syringe access points. We further dismantle barriers through research, advocacy, consumer, and provider education.

Research

• A number of studies found that the distribution of safer smoking kits increases safer smoking techniques and practices, and significantly decreases injection practices 

• The Utilization and Delivery of Safer Smoking Practices and Services: A Narrative Synthesis

• Smoking of crack cocaine as a risk factor for HIV infection among people who use injection drugs

• Combining respondent-driven sampling with a community-based participatory action study of people who smoke drugs in two cities in British Columbia, Canada

• Safe inhalation pipe provision (SIPP): protocol for a mixed-method evaluation of an intervention to improve health outcomes and service engagement among people who use crack cocaine in England

• The Global State of Harm Reduction (First international report to list safer smoking as metric for success worldwide)

• Legality of drug checking equipment in US 

• High levels of interest in access to free safer smoking equipment to reduce injection frequency among people who inject drugs in Seattle, Washington

• Laws that Criminalize Paraphernalia Increase Drug-Related Harm and Should Be Repealed

• Hoots and harm reduction: a qualitative study identifying gaps in overdose prevention among women who smoke drugs

• Examining prevalence and correlates of smoking opioids in British Columbia: opioids are more often smoked than injected

• Distribution of Safer Drug Smoking Supplies as a Public Health Strategy: Addictions, Drug & Alcohol Institute

• Distributing Safer Smoking Supplies Can Help Reduce Health Risks of Opioid/Stimulant Use