ArticleThe International journal on drug policy2022
Consuming illicit opioids during a drug overdose epidemic: Illicit fentanyls, drug discernment, and the radical transformation of the illicit opioid market.
Article in The International journal on drug policy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
38 citing papers in PubMed, 60 citations in OpenAlex.
- Drug sellers' use of a drug checking service amid the overdose crisis in British Columbia, Canada.Addiction (Abingdon, England) · 2026Article
- Navigating an unpredictable supply: lived experiences of xylazine exposure among people who use drugs.Harm reduction journal · 2026Article
- Novel Swine Model of Respiratory Depression Induced by Fentanyl and Heroin Overdose.Research square · 2026Article
- Fentanyl use among people who inject drugs in two large Pacific Northwest metropolitan areas.Harm reduction journal · 2026Article
- Navigating an Unpredictable Supply: Lived Experiences of Xylazine Exposure Among People Who Use Drugs.Research square · 2026Article
- Harm reduction vending machines as safer supply-supporting infrastructure.Frontiers in psychiatry · 2026Article
- Article
- Mini-review: Harm reduction strategies among people who intentionally use fentanyl.Addictive behaviors reports · 2025Article
- An "On-Off" AIE-Based Lock-and-Key Fluorescent Probe System for Detection of Fentanyl/Norfentanyl.Molecules (Basel, Switzerland) · 2025Article
- Serious Bacterial Infections and Hepatitis C Virus Among People Who Inject Drugs: A Syndemic or Intertwined Epidemics?Tropical medicine and infectious disease · 2025Article
- Decrease in injection and rise in smoking and snorting of heroin and synthetic opioids, 2000-2021.Drug and alcohol dependence · 2024Article
- How substance use preferences and practices relate to fentanyl exposure among people who use drugs in Rhode Island, USA.Drug and alcohol dependence reports · 2024Article
- "If everyone knew about this, how many lives could we save?": Do drug suppliers have a role in reducing overdose risk?Drug and alcohol dependence reports · 2024Article
- Estimating changes in overdose death rates from increasing methamphetamine supply in Ohio: Evidence from crime lab data.Drug and alcohol dependence reports · 2024Article
- Examining the Gateway Hypothesis and Mapping Substance Use Pathways on Social Media: Machine Learning Approach.JMIR formative research · 2024Article
- "It gets you high as a kite but not unsick": Characterizations of and responses to a changing local drug supply by people who use drugs in Rhode Island.The International journal on drug policy · 2024Article
- Motivation and context of concurrent stimulant and opioid use among persons who use drugs in the rural United States: a multi-site qualitative inquiry.Harm reduction journal · 2024Article
- Longitudinal patterns of use of stimulants and opioids in the AIDS linked to the IntraVenous experience cohort, 2005-2019.The International journal on drug policy · 2024Article
- The influence of transformations in supply on methamphetamine initiation among people injecting opioids in the United States.Harm reduction journal · 2024Article
- Forecasting drug-overdose mortality by age in the United States at the national and county levels.PNAS nexus · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundNorth America continues to face an opioid overdose epidemic, driven by persistent increases in illicit fentanyls and fluctuations in potency leading to uncertainty for consumers. This qualitative study was conducted to better understand how people who inject drugs (PWID) came to recognize fentanyl as a growing adulterant of heroin and the subsequent sensory discernment strategies they employed to continue injecting. Our main objective was to investigate how observations and knowledge are combined as homegrown techniques for detecting fentanyl and minimizing risk. Secondary objectives were to examine the impact of growing fentanyl adulteration on individual drug use behavior.
methodsBetween April and May 2019, 28 PWID (18 men, 10 women; average age = 38.43 years, SD = 9.26) were purposely recruited from a needle services program in Greensboro, North Carolina. Study participants were interviewed in-person using a qualitative, semi-structured instrument. Interviews were analyzed with a general inductive approach using NVivo12.
resultsParticipants described methods for detecting fentanyl in illicit opioids. Sudden increases in the potency of the 'rush' and sharp decreases in the length of the 'high' were chief indicators along with changes in drug color and texture. Heavy sedation was associated with fentanyl use and histamine-releasing effects characterized as 'pins and needles' were ascribed to injecting fentanyl as a component of the rush. Fentanyl's short high helped explain higher injection frequency and heavy sedation was the leading reason for co-using fentanyl with cocaine/crack or methamphetamine.
conclusionPWID have the capacity to recognize changes to the illicit opioid supply. Study participants navigated unpredictable fluctuations in the illicit opioid market by employing homegrown discernment techniques, modifying drug use behavior, and co-using non-opioid drugs. Researchers and policymakers should involve PWID as subject matter experts to help modernize harm reduction for the fentanyl age with practical strategies to boost resiliency and save lives.
Indexed as
Identifiers
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.