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Changes in injecting versus smoking heroin, fentanyl, and methamphetamine among people who inject drugs in San Diego, California, 2020-2023. | LitMetric

AI Article Synopsis

  • A study conducted in San Diego from October 2020 to April 2023 examined how the changing drug supply affected people who inject drugs, focusing on opioids and methamphetamine.
  • Among 362 participants, the data showed a significant decline in injecting these drugs, with many transitioning to smoking instead, with 34% only smoking by the latest period.
  • Health implications of this shift are concerning, as the risk of smoking fentanyl and other drugs has risen, highlighting the need for more research on the consequences of these behaviors.

Article Abstract

Background: Amidst an increasingly toxic drug supply in North America, people who inject drugs may be transitioning to smoking them. We aimed to assess changes in injecting and smoking opioids and methamphetamine among a cohort of people who inject drugs from San Diego, California.

Methods: Over five six-month periods spanning October 2020-April 2023, we assessed prevalence of injecting and smoking opioids or methamphetamine and whether participants used these drugs more frequently by smoking than injecting. Multivariable Poisson regression via generalized estimating equations was used to examine time trends.

Results: Of 362 participants, median age was 40 years; a minority were female (29%), Hispanic/Latinx/Mexican (45%), and housed (33%). Among this cohort, of whom 100% injected (and 84% injected and smoked) in period one (October 2020-April 2021), by period five (November 2022-April 2023), 34% only smoked, 59% injected and smoked, and 7% only injected. By period five, the adjusted relative risk (aRR) of injecting opioids was 0.41 (95% Confidence Interval [CI]: 0.33, 0.51) and the aRR for injecting methamphetamine was 0.50 (95% CI: 0.39, 0.63) compared to period one. Risks for smoking fentanyl rose significantly during period three (aRR=1.44, 95% CI: 1.06, 1.94), four (aRR=1.65, 95% CI: 1.24, 2.20) and five (aRR=1.90, 95% CI: 1.43, 2.53) compared to period one. Risks for smoking heroin and methamphetamine more frequently than injecting these drugs increased across all periods.

Conclusions: Opioid and methamphetamine injection declined precipitously, with notable increases in smoking these drugs. Research is needed to understand the health consequences of these trends.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11463215PMC
http://dx.doi.org/10.1016/j.drugalcdep.2024.111318DOI Listing

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