During qualitative interviews with PWID, they noted that their motivation for switching from injecting tar heroin to smoking fentanyl was related to their difficulties finding easily accessible veins and needing injection assistance.
“What happened was it was getting harder and harder for me to [inject] myself and I was having to rely on other people to [inject] me, having to pay them, and people get irritated when I’d ask them to do that. And it was just easier for me to go and buy some fentanyl and smoke it and get high as f___ and not bother anybody to [inject] or have to pay anybody to [inject] me or whatnot… I was doing heroin and fentanyl, heroin when I was around somebody that could [inject] me and fentanyl when I wasn’t, and then gradually I went all over to fentanyl.”
After switching from injecting heroin to smoking fentanyl, they noticed many benefits ranging from how the drug felt to improved health, fewer financial constraints, and reduction in stigma. In terms of how the drug felt, they reported that when injecting tar heroin, they would inject the whole drug solution at once, making for a bolus of drug effect immediately that would slowly dissipate with time. By switching to fentanyl, they could smoke a little bit all day long, making for a more even drug effect.