The proportion of U.S. overdose deaths involving both fentanyl and stimulants has increased more than 50-fold since 2010, according to a new report done by researchers at the University of California. What’s especially troubling is that many people who use drugs recreationally, like cocaine, don’t even realize they’re getting a potentially deadly dose of fentanyl. Experts believe that this hidden presence of fentanyl in street drugs is fueling unintentional overdoses.
The study also sheds light on the evolution of the U.S. opioid crisis. It began with an increase in deaths from prescription opioids in the early 2000s (wave 1) and continued with heroin-related deaths in 2010 (wave 2). However, around 2013, a significant spike in fentanyl overdoses marked the onset of a third wave. The fourth and current wave, characterized by fentanyl overdoses combined with stimulants, started in 2015 and shows no signs of stopping.
As Emily’s Hope reported yesterday, new data from the U.S. Centers for Disease Control and Prevention reveals that drug overdose deaths in the United States have once again soared to record levels. The provisional data indicates 111,355 lives were lost due to drug overdoses in the 12-month period ending in April. This surpasses the previous record of 110,757 deaths in the 12-month period ending December 2022.
“We’re now seeing that the use of fentanyl together with stimulants is rapidly becoming the dominant force in the US overdose crisis,” lead study author Joseph Friedman said in a statement. “Fentanyl has ushered in a polysubstance overdose crisis, meaning that people are mixing fentanyl with other drugs, like stimulants, but also countless other synthetic substances. This poses many health risks and new challenges for healthcare providers. We have data and medical expertise about treating opioid use disorders, but comparatively little experience with the combination of opioids and stimulants together, or opioids mixed with other drugs. This makes it hard to stabilize people medically who are withdrawing from polysubstance use.”
The study also highlights the disproportionate impact of fentanyl-stimulant overdose deaths on racial and ethnic minorities in the U.S., including Black and African American individuals and Native Americans. For example, in 2021, stimulant involvement in fentanyl overdose deaths was particularly prevalent among older Non-Hispanic Black or African American women (73%) and Black or African American men (69%) living in the western U.S., compared to a rate of 49% among the general population.
Geographically, there are distinct patterns in the types of stimulants combined with fentanyl. In the northeast U.S., fentanyl is commonly mixed with cocaine, while in the southern and western regions, it is more frequently found alongside methamphetamine.
“We suspect this pattern reflects the rising availability of, and preference for, low-cost, high-purity methamphetamine throughout the U.S., and the fact that the Northeast has a well-entrenched pattern of illicit cocaine use that has so far resisted the complete takeover by methamphetamine seen elsewhere in the country,” Friedman said
To address this crisis, experts recommend taking proactive measures, such as keeping fentanyl test strips and naloxone readily available. Narcan, a naloxone product that can reverse opioid overdoses, is now available to buy over-the-counter, without a prescription.