What is it about?

The rise in smoking fentanyl has elements of both innovation and adaptation. It is innovative in that while some other drugs are considered smokable, this was rare for fentanyl until recently when some adopted and promoted it. It has signs of adaptation in that many fentanyl smokers believe it is less risky regarding overdose compared with injecting.

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Why is it important?

The rise in the culture of smoking fentanyl has several important issues to consider: 1. It has proven so popular an innovation in some areas that it will likely spread across the US 2. Observations confirm the possibility that smoking is less risky for overdose, e.g., by using smaller doses at a time and with slower intake 3. The risk of overdose may be increased however as some consumers take "big hits" 4. And we discovered a new risk factor for overdose: the residual, or resin, remaining in pipes after smoking reportedly remained a strong and active substance. This resin can be collected, reused, shared, and stolen. It represents a risk to those who have lower tolerance.

Perspectives

The paper highlights the value of ethnographic and qualitative research in exploring new drug trends and use patterns.

Dan Ciccarone
University of California San Francisco

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This page is a summary of: Innovation and adaptation: The rise of a fentanyl smoking culture in San Francisco, PLoS ONE, May 2024, PLOS,
DOI: 10.1371/journal.pone.0303403.
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