SMOKE IT! Promoting a change of opiate consumption pattern - from injecting to inhaling

Abstract

BackgroundIntravenous drug use has been predominantly practised since illegal heroin use became known in Germany in the early 1970s. The available data suggest that the risk of accidental overdose when smoking heroin is substantially reduced compared to injecting a substance of unknown purity and quality. Moreover, the risk of transmitting HIV, Hepatitis B or C via blood contact is considerably reduced when smoking heroin rather than when injecting it intravenously. In spite of the significant strain on the lungs and the respiratory tract caused by smoking, it can be concluded that inhalative use - measured by the indicators ‘overdose’ and ‘viral infections’ is considerably less dangerous than intravenous use. Despite these harm-reducing effects of inhalative use, there is only very limited scientific survey on this subject. The project ‘SMOKE IT!’ studied to what extent a change of the consumption method can be supported by making new equipment for drug use available.Method‘SMOKE IT!’ was carried out as a multi-centre survey in drug consumption rooms (DCRs) in five German cities. Participants received ‘SMOKE-IT!’ packs that contained new heroin smoking foils, as well as information about inhalative drug use. The quantitative data collection was aided by a written questionnaire filled out at three different stages in 2012.ResultsThe vast majority of the 165 respondents favoured using the foils from the ‘SMOKE-IT!’ packs (82.5%). The survey shows that two-thirds of the sample used the SMOKE-IT foils for inhaling instead of injecting. Almost six out of ten said that smoking was healthier than injecting. Thirty-five percent of the participants named the reduced risk of a hepatitis or HIV infection as a particularly important factor. A third of the respondents used the smoking foils to avoid the danger of an overdose.ConclusionsTargeted media and personal intervention in association with the dispensation of attractive drug use equipment can motivate opiate users to change their method of drug use. The main reason for inhalative use is that it is significantly less dangerous, measured by the indicators ‘overdose’ and ‘viral infections’. All drop-in centres should expand their syringe-exchange services to include the dispensation of smoking foils.

The effect of methamphetamine abuse on dental caries and periodontal diseases in an Eastern China city

“…It can even result in death if not treated immediately [ 14 , 15 ]. In the past several decades, intravenous drug use has been predominantly practised, which increased the risk of transmitting infectious diseases via blood contact, such as HIV, Hepatitis B or C [ 16 ]. Thus, above-mentioned systemic diseases are considerable public concern for drug users.…”

Estratégias de redução de danos no uso prejudicial de álcool e outras drogas: revisão de literatura

“…Needles, syringes and pipes are also included in some kits. The distribution of these materials occurs in a variety of ways: in health care spaces, at areas of use by AHR or in mutual health groups and counselling, as noted in the accounts of the experience in Brazil 12,46,51 and Tanzania 42…”

“…In the Czech Republic 50 gelatin capsules containing the desired quantity of methamphetamine is dispensed for oral consumption. In the Chinese experience heroin was offered to be smoked as a possibility to reduce consumption or to help user with damaged veins, reducing the risk of overdoses 51 .…”

A primary care database study of asthma among patients with and without opioid use disorders

“…Lack of healthcare utilisation may explain why outcomes amongst people with asthma and SUD appear to be so poor, but the nature of specific illicit drug use might also be a significant additional factor for those with OUD. As a part of the harm minimisation paradigm, injecting heroin users were encouraged to adopt alternative routes of drug use and by the late 1990s, inhalation became a common method of administration in many countries 14,15 . These 'route transition interventions' were aimed at reducing the risk of fatal overdose, blood-borne virus transmission and intravenous drug injection-associated infections.…”