Theme: Social Science & Policy Research Year: 2024
Background:
A growing body of evidence indicates that people who use unregulated drugs have been transitioning from injecting to smoking their drugs. This has occurred in tandem with the escalating drug toxicity crisis in North America, which is driven by a highly volatile drug supply and increasing stimulant-fentanyl polysubstance use. In BC, drug smoking is now the primary mode of consumption for drug toxicity deaths. This presentation explores the shift from injecting to smoking unregulated drugs.
Methods:
We conducted qualitative interviews with 31 people who smoke drugs. Interviews covered a range of topics including motives for transitioning from injecting to smoking drugs. Thematic analysis was used to identify drug smoking factors.
Results:
Thirty-one individuals including 20 men, 10 women and 1 non-binary person participated in this study.. We identified three main themes related to the shift from injecting to smoking drugs, which can be attributed to the evolving toxic drug supply: a) trouble injecting due to collapsed veins, b) having more control over drug consumption to reduce overdose risk, and c) the accessibility of drug smoking compared to injecting. Structural vulnerabilities, including having to frequently use drugs outdoors and reliance on the contaminated drug supply, r shaped drug smoking practices to mitigate adherent risks of drug use.
Conclusion:
Our findings demonstrate that the increase in drug smoking is being driven by factors associated with a reliance on the toxic unregulated drug market, which include the frequency with which fentanyl is injected/consumed and the associated loss of accessible veins, increasing stimulant and stimulant-fentanyl polysubstance use, as well as the heightened overdose risk from unregulated fentanyl use. These findings highlight the need to expand public health and harm reduction measures for people who smoke unregulated drugs.