Eight participants, who were exclusively heroin snorters, were also interviewed. Experience injecting heroin ranged from < 1–47 years. Ninety-one current heroin injectors were interviewed (Baltimore, n = 22 Chicago, n = 24 Massachusetts and New Hampshire, n = 36 San Francisco, n = 9). Methodsīetween 20, a team of ethnographers collected data through semi-structured interviews and observation captured in field notes and video recording of heroin preparation/consumption. This paper considers the adaptations some US heroin injectors are making to protect themselves from these risks. However, since 2001, heroin-related overdose deaths in the United States (US) have risen sixfold, paralleled by a rise in the death rate attributed to synthetic opioids, particularly the fentanyls. Internationally, overdose is the primary cause of death among people injecting drugs.
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