More people in US are dying from smoking drugs than injecting them

Findings can help inform public health and harm reduction services to reduce overdose deaths, scientists say

More people in the US are now dying of overdose from smoking drugs than taking them via injections, a new study has found.

The study conducted by the US Centers for Disease Control and Prevention (CDC) found that the percentage of overdose deaths with evidence of smoking surged by nearly 75 per cent, while the percentage of drug injection-related deaths decreased by about 30 per cent between the period January-June 2020 to July–December 2022.

Researchers found that the changes were most pronounced in deaths where illegally manufactured fentanyls (IMFs) were detected.

The findings, according to the CDC, can help inform public health and harm reduction services to address overdose risks with smoking and reduce deaths.

In the study, researchers analysed data from the State Unintentional Drug Overdose Reporting System to describe trends in routes of drug use in 27 states and the District of Columbia.

They found that deaths with evidence of smoking more than doubled from 2,794 to 5,843 during the study period, and by 2022, smoking was the “most commonly documented route of use in overdose deaths.”

“Trends were similar in all US regions,” the CDC noted.

This change, researchers suspect may be indicative of transition from injecting heroin to smoking IMFs among drug users.

An increasing number of deaths might also involve a combination of IMFs and stimulants that may be smoked, according to the study.

There may also be reduced cost and less perceived stigma associated with smoking drugs as opposed to injecting them, the CDC report noted.

“Despite some risk reduction associated with smoking compared with injection (fewer bloodborne infections), smoking carries substantial overdose risk because of rapid drug absorption,” researchers said.

Citing some limitations of the study, researchers said they could not determine the how and why specific overdose deaths, especially when witnesses were not present.

Injections may also be more reported when it is the route of drug use as they leave behind marks on the body as opposed to smoking.

However, scientists say the findings can still help reduce overdose deaths.

They call for expanded public health messaging emphasising overdose risk linked to smoking and other routes of drug use.