Severe burns from smoking opioids a new factor in harm reduction

The landscape of drug use in the United States has seen a significant shift from injecting to smoking in recent years. This transformation has been largely viewed as positive by public health experts, as smoking drugs like fentanyl can potentially reduce the risk of infections, disease transmission, and overdoses. However, a new study published this week has shed light on a previously overlooked consequence of this shift: an increased risk of severe burns among individuals who smoke drugs.

According to the study, individuals who smoke drugs such as fentanyl or methamphetamine are four times more likely to be treated at an acute burn care unit compared to those who do not use smokable drugs. The analysis was based on Medicaid claims data in Oregon between 2016 and 2024, revealing that smoking opioids or stimulants was associated with higher rates of severe burns. In fact, the study found that half of emergency department visits and hospitalizations for burns in Oregon were among people who use smokable drugs, despite comprising only 15% of the population.

The prevalence of severe burns among individuals who smoke drugs can be attributed to the use of powerful butane torches commonly used for heating drugs. These torches, favored for their intensity and wind resistance, can lead to devastating consequences when combined with altered consciousness resulting from drug use. One patient recounted a friend who sustained a severe burn without even waking up during the incident.

The study was initiated after reports from a surgeon specializing in burns in Oregon, who observed a significant number of serious burns associated with drug use. While the research provides valuable insights into the risks associated with smoking drugs, it also raises questions about how these risks compare to other health outcomes like overdose or HIV.

Despite the challenges in directly comparing burn rates with other health risks, the study underscores the importance of promoting safer smoking practices among drug users. Clinicians and harm reduction advocates are encouraged to educate individuals on the risks associated with using powerful torches and to recommend the use of safer alternatives like soft flame lighters. By raising awareness about the potential dangers of smoking drugs, efforts can be made to mitigate the risk of severe burns in this population.

In conclusion, while the shift from injecting to smoking drugs may offer certain benefits, such as reducing infection rates, it is crucial to address the emerging issue of severe burns among individuals who smoke drugs. By promoting safer practices and providing education on the risks associated with different modes of drug use, healthcare providers and advocates can work towards ensuring the well-being of individuals engaged in drug consumption.