SAFER SMOKING SAVES LIVES
For years law enforcement, public health officials and the press have reported that drug dealers routinely and intentionally adulterate drugs from marijuana to cocaine with high potency fentanyl from Mexico. In the rare cases where independent laboratory analysis is even conducted on a suspected fentanyl-laced drug sample (such as CFSRE's analysis in 2023 of CBD gummies widely reported of being tainted with fentanyl) the drug is ultimately ruled out. The most misunderstood drug as it relates to fentanyl adulteration is cocaine, and reports of opioid naive people overdosing on fentanyl after consuming what they believed to be cocaine have proliferated for years.However, forensic evidence backing this up is virtually nonexistent. Indeed, lab-based mass spectrometry analysis shows retail -level drugs sold as fentanyl are far more likely to contain cocaine than cocaine is to contain fentanyl.
Thanks to the emerging field of community drug checking and information provided by supply side sources we can now say conclusively that cocaine laced with fentanyl is exceeding rare. Out of more than 500 drug samples tested last year by PA GROUNDHOGS only one cocaine sample and one methamphetamine sample tested positive for fentanyl. In both cases the amount of the drug present in trace amounts, probably the result of cross contamination, and in insufficient quantities to cause an overdose. But the fact remains more people than ever are overdosing on fentanyl/stimulant combinations; and increased poly drug use is only one factor.
So what is going on?
PLEASE PRINT FLYER BELOW & DISTRIBUTE
Shift to Smoking
From January–June 2020 to July–December 2022, the percentage of overdose deaths with evidence of smoking increased 73.7%, and the percentage with evidence of injection decreased 29.1%, according to the Centers for Disease Control & Prevention. The vast majority of these deaths involved illegally manufactured fentanyl. As the practice of smoking fentanyl has increased significantly, both fatal and nonfatal ODs have also increased among the stimulant-using community, particularly in Black communities. In October, 2023, Narcomedia.org conducted interviews with people who smoke crack in the predominantly Black community of West Philadelphia and uncovered a disturbing practice: Fentanyl users who also smoke crack cocaine were using their crack stems to ingest both drugs and then passing that pipe on to others to use. Sharing stems (or straights) is a common practice among crack users who may be compensated for sharing their stem with a piece of the drug or leftover cocaine residue when they "push" their pipe. For the opioid naive, this ritual now runs the risk of causing an overdose. In West Philadelphia, almost everyone we spoke with new someone who fell out after smoking from a crack stem that had previously been used to smoke fentanyl. In some cases naloxone was required. One man described overdosing twice after taking a hit off a shared stem. In May 2024, researchers at the University of California San Francisco (UCSF) released the first qualitative study on the link between sharing smoking equipment and fentanyl overdose. Its lead author, Dan Ciccarone, called for "...culturally attuned education campaigns..to address this new risk.”
