Fentanyl’s Alarming New Trend in San Francisco

This research approach surfaced a variety of information on the participants’ experiences, such as their motivations for smoking fentanyl, smoking techniques and behaviors, and the potential risks involved.

Many participants reported that fear of overdose and the challenges of injecting had prompted their transition from injection to smoking. However, some expressed belief that smoking fentanyl still poses high overdose risk—more research is needed to determine whether smoking may be less harmful than injection in relation to overdose risk.

Social Dynamics and Health Concerns

The study also highlighted the social nature of smoking fentanyl, with some participants reporting sharing equipment and drugs. However, some were wary of hygiene and overdose risks to others from sharing. In particular, concerns were raised about fentanyl “residue” that accumulates on equipment, which can be consumed and shared but poses a risk of overdose due to the potential mismatch between a person’s tolerance and residue potency.

Conclusions and Future Directions

The research team notes that this study is exploratory and has limited generalizability beyond its participants and local context. However, this innovation will likely become more widespread as the advantages of smoking over injection become apparent.

Dan Ciccarone adds: “We explored the culture of smoking as an adaptation to the use of the potent synthetic opioid fentanyl. This innovation is powerful and will likely spread beyond its west coast roots to more of the US.”

For more on this study, see The Lethal Risks of Fentanyl Residue in Smoking Devices.

Reference: “Innovation and adaptation: The rise of a fentanyl smoking culture in San Francisco” by Daniel Ciccarone, Nicole Holm, Jeff Ondocsin, Allison Schlosser, Jason Fessel, Amanda Cowan and Sarah G. DOI: 10.1371/journal.pone.0303403

The research was funded by The US