A recent article published by the Oregon Public Broadcasting (OBS) and authored by Amelia Templeton discussed a new health risk linked to drug use, especially smoking fentanyl and other substances. The article also examined recent research showing that smoking substances, particularly with butane torches, can lead to severe, life-threatening burns, an often overlooked consequence compared to overdose risks.
“[The patients are] passing out with that butane lighter on their legs, in their lap, in their hands,” he said. “It’s leading to these devastating injuries,” said Dr. Mark Thomas, a surgeon at the Oregon Burn Center at Legacy Emanuel Medical Center in Portland.
Dr. Thomas was also a co-author on a research study published in the peer-reviewed journal JAMA Internal Medicine that used insurance claims data from the Oregon state Medicaid program, revealing that over half of people treated for burns in hospitals and emergency rooms in Oregon between 2016 and 2024 used smokable drugs other than tobacco, including opioids, stimulants, and cannabis. Moreover, the results revealed that burn rates for individuals smoking opioids or stimulants was four times higher compared to individuals who did not smoke illicit drugs.
In recent years, opioid use in the U.S. has shifted from injection to smoking, especially on the West Coast. While smoking illicit drugs reduces risks of HIV and infections, it is now the leading method linked to overdose deaths. In his interview with the OBS, George Karandinos, a physician anthropologist at Massachusetts General Hospital, said that every way of using drugs has its own risks, and that the study showing the burn risk is important because it means healthcare providers should start addressing and discussing these injuries. “I think it’s really, really critical work and should become a part of harm reduction practice,” he said. “It’s only going to become more important.”
Although fentanyl use and smoking have increased, burn rates stayed relatively stable, and researchers have suggested that this discrepancy may reflect limitations in the Medicaid data. However, the study did determine that the most probable cause for severe burns in individuals who smoke illicit drugs is the use of butane torches. “The potency of fentanyl overwhelms your system. If you don’t have control of that heating source, you’re going to get severely injured,” said Dr. Thomas.
