After nearly two and a half decades of steadily increasing overdose rates in the U.S., there has been a dramatic decline in drug-related deaths over the last few years. There are many reasons for this change, not least of which is a marked decrease in the purity of fentanyl, the substance that has been largely driving the overdose epidemic. But other factors are at play, including a significant behavioral shift in fentanyl users — they are increasingly switching from injecting drugs to smoking them.
Outreach worker Megan Merrill sees it every day. “They’re definitely smoking their drugs more than they’re injecting it,” she said of the unhoused community she serves, “and I really think it has to do with the supply and like, their veins are just shot.”
Harm reduction organizations simply making smoking supplies like pipes and foil more readily available is accelerating the shift to the safer practice of smoking, said Jim Duffy of Smoke Works Injection Alternatives. Duffy’s company supplies inexpensive glass pipes and other harm reduction products to organizations like New Hampshire’s SOS.
“People were using syringes because that’s all that was offered. The demand for smoking supplies was there. But pipes were never on the table,” said Duffy. “It wasn’t long into pipe distribution at the [syringe] exchange that we had people putting syringes back in our hands and saying, no, I’ll just take the glass.”
In this week’s STATus Report, host Alex Hogan and STAT addiction reporter Lev Facher visit Duffy’s distribution warehouse in Braintree, Mass. They then ride along with SOS’ Merrill during her outreach work, including handing out glass pipes, at an encampment deep in the woods of New Hampshire.
