From 2020 to 2022, there was an increase in the percentage of overdose deaths with evidence of smoking, according to research published in the Feb. 15 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.
Lauren J. Tanz, Sc.D., from the CDC in Atlanta, and colleagues describe trends in routes of drug use in 27 states and the District of Columbia among overdose deaths occurring during January 2020 to December 2022.
The researchers found that from January-June 2020 to July-December 2022, there was a 29.1 percent decrease in the percentage of overdose deaths with evidence of injection, from 22.7 to 16.1 percent, and a 73.7 percent increase in the percentage with evidence of smoking, from 13.3 to 23.1 percent. A 109.1 percent increase was seen in the number of deaths with evidence of smoking, from 2,794 to 5,843; smoking was the most commonly documented route of use in overdose deaths by 2022. In all U.S. regions, the trends were similar. Among deaths with only illegally manufactured fentanyl and fentanyl analogs (IMFs), there was a 41.6 percent decrease in the percentage with evidence of injection (from 20.9 to 12.2 percent) and a 78.9 percent increase in the percentage with evidence of smoking (from 10.9 to 19.5 percent). Among deaths with both IMFs and stimulants detected, similar trends were seen.
Black men are among the most affected by fentanyl overdoses, who are 9.4 times more likely to die from it than white men.
“Although unsafe injection drug use practices might be most risky in terms of infectious disease transmission, other routes, particularly smoking, still carry substantial overdose risk,” the authors write.