Drug injection fades as smoking grows more common, marking sea change in U.S. fentanyl epidemic

In the last decade, U.S. drug consumption behavior has shifted rapidly away from injecting and toward smoking. Once largely limited to the West Coast, a preference for smoking opioids has spread east since the Covid-19 pandemic, becoming especially pronounced in hard-hit cities like Philadelphia. The shift has taken place largely organically, making it a case study in how the U.S. health infrastructure has ignored the input of drug users — even when the outcomes they seek could reduce death, prevent disease, and save taxpayers millions of dollars.