Observational studyDrug and alcohol dependence2021
Transition from injecting opioids to smoking fentanyl in San Francisco, California.
Observational study in Drug and alcohol dependence, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 94 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
94 citing papers in PubMed, 149 citations in OpenAlex.
- The Emergency Department Longitudinal Integrated Care (ED-LINC) intervention targeting opioid use disorder: A pilot randomized clinical trial.Journal of substance abuse treatment · 2022Trial
- Daily patterns of opioid and stimulant use and associated risk-behavior outcomes: A cohort study.Addictive behaviors · 2026Article
- Multilevel drivers and constraints of shifts from injecting to smoking opioids and stimulants: A qualitative study from the San Diego-Tijuana border region.Drug and alcohol dependence · 2026Article
- County by county estimation of possible deaths averted, infections averted, and cost savings of overdose prevention centers in the United States from July 2019-June 2025.The International journal on drug policy · 2026Article
- Social, Economic, and health risks among people who use Methamphetamine: Comparing three patterns of opioid Co-Use.Addictive behaviors reports · 2026Article
- Crack/cocaine use to manage xylazine exposure in fentanyl in Connecticut: findings from a convergent mixed methods study.Harm reduction journal · 2026Article
- The changing contribution of fentanyl use to non-fatal overdose among a cohort of people who inject drugs in San Diego, California: A longitudinal assessment.Drug and alcohol dependence · 2026Article
- County by county estimation of possible deaths averted, infections averted, and cost savings of overdose prevention centers in the United States from July 2019-June 2025.medRxiv : the preprint server for health sciences · 2026Article
- Fentanyl use among people who inject drugs in two large Pacific Northwest metropolitan areas.Harm reduction journal · 2026Article
- The relationship between injection status, cocaine use, overdose, and drug-related behaviors among people who use opioids.Drug and alcohol dependence reports · 2026Article
- A comprehensive review of state laws that govern the distribution and possession of drug use equipment in the United States.The International journal on drug policy · 2026Review
- Prevalence of Illicit Drug Detection in 5 US Cities Among Out-of-Treatment People Who Inject Drugs.JAMA network open · 2026Article
- Linkage to Substance Use Disorder Treatment Through Syringe Services Programs and the Criminal Legal System: A Cross-Sectional Study.American journal of preventive medicine · 2026Article
- Sociodemographic, behavioral, and geospatial factors associated with syringe services program use in San Francisco, California.Drug and alcohol dependence · 2026Article
- A Mobile Health Application to Support Reductions in Overdose Risk Behaviors: A Pilot Study.Substance use & addiction journal · 2026Article
- Integration of safer smoking equipment in U.S. syringe services programs: Qualitative insights from program staff.The International journal on drug policy · 2026Article
- Stability or versatility: transitions in fentanyl routes of administration.Harm reduction journal · 2025Article
- Use of Illegally Manufactured Fentanyl in the United States: Current Trends.Current addiction reports · 2025Article
- Association of route of drug administration with self-reported non-fatal overdose: A cohort study of Baltimore City adults who have injected drugs.Drug and alcohol dependence · 2025Article
- Early evidence of the effects of xylazine-adulterated fentanyl in Ohio.The International journal on drug policy · 2025Article
34 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe introduction of illicitly made fentanyl in the United States has slowly replaced heroin. New illicit drugs are often associated with changes in frequency and modes of administration. We assessed changes in injection frequency and smoking fentanyl in the new era of fentanyl availability in San Francisco.
methodsWe used targeted sampling to recruit 395 people who inject drugs (PWID) into an observational cohort study in San Francisco 2018-2020. We assessed changes in injection frequency, opioid injection frequency and fentanyl smoking frequency in four six-month periods. We also conducted qualitative interviews with PWID asking about motivations for injecting and smoking opioids.
resultsThe median number of past-month injections steadily decreased by semi-annual calendar year from 92 injections in July to December 2018 to 17 injections in January to June 2020. The rate of opioid injections reduced by half (Adjusted Incidence Rate Ratio = 0.41; 95 % Confidence Interval = 0.25, 0.70; p < 0.01). The number of days smoking fentanyl was associated with fewer number of injections (X
conclusionBetween 2018 and 2020, there was a shift from injecting tar heroin to smoking fentanyl in San Francisco. Reductions in injection of illicit drugs may offer public health benefit if it reduces risk of blood-borne viruses, abscesses and soft-tissue infections, and infective endocarditis.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.