Smoking is the process of burning a substance and the smoke then being inhaled into the lungs. The most well-known smoking drug is tobacco. Although the chemical properties of other drugs which are smoked vary, the way they are absorbed into the body is the same. The most commonly smoked drugs after tobacco are cannabis, heroin and crack cocaine.

Safer Administration

  • Smoking equipment, e.g. pipes should not be shared
  • When chasing, use foil provided from needle exchanges if possible. If not, use aluminium. Kitchen/cooking foil is often coated with vegetable oil which needs burnt off the surface.  Do not use foil from sweet packaging as it is often covered with contaminants.
  • If you are smoking substances in cigarettes or joints – use unbleached card to make filters to avoid breathing in harmful substances from the card

Methods Of Smoking

Smoke can be inhaled from a lit cigarette, a pipe or by inhaling smoke / fumes from a heated substance through foil (heroin smoking).

The smoke is drawn into the lungs and passes through the lining of the lungs into the bloodstream. It is then pumped through the heart and on to the brain.

This is a very efficient method of taking drugs, as the active ingredients are mixed with oxygenated blood and travel to the brain quite quickly. The effects are felt almost immediately. However, some of the drug will be lost as it literally goes up in smoke.

The Health Risks Of Smoking

The tissues of the mouth, airways and lungs are not meant to take in hot, noxious gases of any kind. In the long-term this may lead to problems such as cancers of the tongue, throat and larynx, and chest diseases like bronchitis, emphysema and lung cancer.

The case against smoking tobacco as a cause of all these health problems is well established but that against other smoking drugs is less clear. This may be because it is rare for other drugs to be taken as frequently and continuously as tobacco. It may also be because of the difficulties in researching populations using illegal drugs. In the case of cannabis it seems likely that adding the cannabis to tobacco will increase the risks of respiratory system diseases. There is also the added risk in this case of occasional cannabis users becoming dependent on tobacco.

Dependency Risks

The second set of risks relates to problems of dependency. Because smoking a drug delivers a very quick effect or ‘hit’ the doses taken are often quite small. If the drug smoked also has a fast elimination rate from the bloodstream, which is the case with the stimulant drugs tobacco and crack cocaine, then the rate of drug in the bloodstream fluctuates rapidly.

The drug effect is felt quickly and disappears quickly. This can lead to bingeing with a series of repeated use of the drug to sustain the effect. The user rapidly experiences the sensation of the drug which is very quickly followed by its absence. This leads to a sensation of craving for the drug which can be satisfied by having some more immediately.

With tobacco this is called chain smoking, but it is also well known with crack cocaine. In this latter case and given the extra power of the drug, it can lead to serious problems of overstimulated, aggressive, or even psychotic behaviour. To make matters worse crack is very expensive if used in this way and hundreds of pounds worth of the drug can be binged in a single day.

Smoking Or Injecting?

In view of the above it seems reasonable to ask if smoking a drug is the most dangerous way of taking it. The answers is – it depends. If the alternative as with street heroin, is injecting then the answer must be no. Injection of a drug carries such exceptional risks that smoking, despite its problems is much less risky.

If the alternative is snorting or eating the drug as with cocaine or cannabis, then smoking it might be more risky. In the attempt to encourage heroin users to eat rather than inject their drugs there are also programmes which provide free methadone or other opioids in syrup or tablet form.