OVERDOSE DEATHS FROM SMOKING DRUGS NOW EXCEED INJECTION

Over the last 3 decades, there have been several fluctuations in opioid use patterns and prevalence estimates in the United States. The predominant opioid involved in overdose deaths shifted from prescription opioids in the 1990’s and early 2000’s, to heroin in 2010, and to synthetic opioids like fentanyl in 2013. Recent estimates suggest that about 70% of drug overdose deaths involve synthetic opioids other than methadone, with fentanyl accounting for the majority of these deaths. Since 2015, there has also been a steady increase in deaths involving both fentanyl and stimulants.

This study investigated whether the predominant route of drug administration involved in overdose deaths has changed over time, as well as the impact of geographic region and drug type on overdose trends. It was a retrospective analysis of national data from the Centers for Disease Control and Prevention’s (CDC’s) overdose reporting system, in which drug overdose trends in the United States were evaluated over a period of 2 years.

There has been a shift in drug-overdose death trends in recent years, with injection-related deaths decreasing and smoking-related deaths increasing. Smoking was the most prominent route of administration involved in drug-related deaths in 2022. These shifts in drug-route trends were most robust for fentanyl-involved deaths and were generally consistent across all U.S. regions. The large majority of overdose deaths that involved smoking, snorting, or ingesting did not also involve injection. Thus, this study highlights the public health benefits of expanding education and harm-reduction services to people engaging in non-injection drug use to combat overdose on a larger scale.