Our new paper is out looking at fentanyl injection and injection practices among people who inject drugs in Toronto. Since fentanyl is a very short-acting opioid, there is concern that increased frequency of injection may be changing injection practices. link.springer.com/article/10.100…

We thank the many people who shared their expertise, experiences and time with our project team. With Gillian Kolla, PhD, Ahmed Bayoumi, Sarah Greig, Molly Bannerman, Debbie Phillips, Jason Altenberg & Carol Strike

We surveyed 249 people who accessed harm reduction services in Toronto and looked at the relationship between the frequency of fentanyl injection and the sharing of injection equipment (filters, cookers and syringes).

We found that people who inject fentanyl daily and people who inject fentanyl less frequently reported the same levels of equipment sharing. But also that both groups who inject fentanyl had significantly higher levels of sharing than people who inject drugs other than fentanyl.

Our results suggest that people who inject fentanyl have higher rates of injection practices that may lead to viral transmission. But these results also countered our hypothesis & prior studies suggesting an association btwn fentanyl injection frequency & injection risk practices

This is important because it indicates that the injection practices of people who used fentanyl in our study may be explained by factors other than how often they injected fentanyl.

We suggest that other explanations could be the cost of fentanyl from the unregulated market, access to drug sellers, lack of money, impacts of criminalization, social processes of altruism or mutual aid, severity of withdrawal, and/or availability of harm reduction services.

Our findings support calls to urgently address the high risk of dual harms from potential HIV/HCV transmission and the ongoing overdose crisis, including urgent action to expand distribution of injection supplies, naloxone, and supervised consumption services.

BUT, with fentanyl as the predominant opioid in the illicit drug supply, evidence from this study also suggests that interventions right now must go further…