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Routes of Drug Use Among Drug Overdose Deaths - United States, 2020-2022
MMWR. Morbidity and Mortality Weekly Report
|February 15, 2024
Summary
Illegally manufactured fentanyl and fentanyl analogs (IMFs) are driving overdose deaths. Data shows a significant shift from injecting drugs to smoking IMFs, which became the most common route of use by 2022.
Area of Science:
- Public Health
- Epidemiology
- Toxicology
Background:
- Over 109,000 drug overdose deaths occurred in the US in 2022, with nearly 70% involving synthetic opioids like fentanyl.
- Illegally manufactured fentanyl and fentanyl analogs (IMFs) are primary drivers of these deaths.
- Emerging data suggested a shift from heroin injection to IMF smoking in the western US.
Purpose of the Study:
- To analyze trends in drug use routes among overdose deaths in the US.
- To examine changes in injection versus smoking as primary routes of drug use.
- To understand the role of IMFs and stimulants in these evolving trends.
Main Methods:
- Analysis of data from the State Unintentional Drug Overdose Reporting System (SUDRS).
- Inclusion of overdose deaths from 27 states and the District of Columbia (January 2020 - December 2022).
- Stratification of data by region, drugs detected, and route of administration (injection vs. smoking).
Main Results:
- Between January-June 2020 and July-December 2022, deaths involving injection decreased by 29.1% (22.7% to 16.1%).
- Deaths involving smoking increased by 73.7% (13.3% to 23.1%), with a 109.1% rise in the number of smoking-related deaths.
- By 2022, smoking became the most commonly documented route of use in overdose deaths, a trend consistent across all US regions.
Conclusions:
- A significant transition from drug injection to smoking is evident in US overdose deaths, particularly involving IMFs.
- This shift necessitates enhanced public health and harm reduction strategies addressing diverse routes of drug use, including non-injection methods.
- Targeting interventions for smoking-related overdose risks is crucial to reduce overall drug overdose fatalities.
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