"Some experts have mischaracterized smoking fentanyl as "safer" than injecting, seeking to reduce risks among users. Narrowly considered, the statement is accurate, as inhalation avoids needle-sharing, reducing risks for HIV, hepatitis C, bacteremia, abscess formation, and infective endocarditis among users. However, there's no clinical-trial-level evidence (randomized trials with real patients) showing smoking illicit fentanyl is safer than injecting it. It isn't, and that conclusion is unsupported by toxicology, environmental exposure science, or emerging data."
"Smoking fentanyl is akin to injection without a needle, but in addition to this, smoking creates environmental contamination and major exposure risks. Evidence from tobacco, cannabis, methamphetamine, and household opioid-smoking indicates such risks exist, not only to users, but also to anyone living in or frequenting the same environment. Secondhand tobacco smoke is firmly established as a cause of cardiovascular disease, lung cancer, asthma exacerbations, adverse pregnancy outcomes, and sudden infant death syndrome."
"More recently, "third-hand" smoke-residual nicotine and combustion byproducts persisting on walls, carpets, clothing, and dust-is recognized as an additional exposure pathway, particularly for infants and young children. Cannabis research in controlled chamber studies has shown non-users in poorly-ventilated environments can absorb measurable Δ9-tetrahydrocannabinol (THC) after secondhand exposure, with detectable biomarkers in blood and urine. (THC is the intoxicating substance in cannabis.) Professor Adrian Bruinjzeel and colleagues have shown that cannabis dependence and withdrawal can then develop."
Smoking fentanyl avoids needle-sharing and thereby reduces risks of bloodborne infections such as HIV, hepatitis C, bacteremia, abscesses, and infective endocarditis. No randomized clinical trials demonstrate that smoking illicit fentanyl is safer than injecting; toxicology, environmental exposure science, and emerging data do not support a safety claim. Smoking fentanyl generates environmental contamination and exposure risks for non-users in the same spaces. Established evidence from tobacco, cannabis, and methamphetamine shows that secondhand and third-hand smoke can produce measurable absorption, toxic effects, dependence, and adverse health outcomes especially for infants and others in poorly ventilated environments. Smoking fentanyl may also facilitate polysubstance practices like speedballing.
Read at Psychology Today
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