Fentanyl use among people who inject drugs in two large Pacific Northwest metropolitan areas

Fentanyl use was highly prevalent among PWID in the urban PNW. Non-injection fentanyl use was most common and street pills were frequently administered by smoking which was associated with injecting less. All fentanyl use was associated with increased risk for overdose. There is ongoing need for access to naloxone for PWID who use fentanyl.