‘Fourth wave’ of opioid crisis marked by meth & cocaine containing fentanyl

Cocaine and methamphetamines have now surpassed heroin and prescription opioids in illicit drug use involving fentanyl nationwide, according to a new report. Researchers are dubbing this the “fourth wave” of overdose deaths.

“These combinations heighten overdose vulnerability and may diminish responses to overdose reversal agents (e.g., naloxone), rendering treatment as challenging as ever before,” reads the Millennium Health report.

In their study, researchers analyzed urine drug test results from more than four million patients who tested positive for fentanyl between 2013 and 2023. Methamphetamine and fentanyl use reached a record high in 2023, while tests indicating prescription opioid mixed with fentanyl declined.

Nearly all fentanyl-positive tests last year contained at least one additional substance, with approximately half containing three or more substances. Sixty percent included meth, marking an 875% increase since 2015. Around a quarter of fentanyl-positive tests contained cocaine, 17% heroin, 14% xylazine, and 7% prescription opioids.

The United States is currently experiencing its deadliest drug epidemic on record, with the Centers for Disease Control and Prevention attributing many of the deaths to fentanyl.