Between 2010 and 2021, the proportion of drug overdose deaths in the US involving a combination of fentanyl and a stimulant such as cocaine or methamphetamine skyrocketed
By Grace Wade
14 September 2023
Opioids and a stimulant such as cocaine make a deadly combination
Shutterstock / Thomas Andre Fure
The proportion of drug overdose deaths in the US involving both fentanyl and stimulants increased more than 50-fold between 2010 and 2021. This surge represents a new phase in the country’s worsening opioid crisis, one characterised by concurrent fentanyl and stimulant use.
Since 1999, drug overdose deaths in the US have steadily risen, primarily due to the spread of prescription and illicit opioids like oxycodone, heroin and, more recently, fentanyl.
To better understand trends in fentanyl use, Chelsea Shover at the University of California, Los Angeles, and her colleagues collected data on overdose deaths between 2010 and 2021 using the US Centers for Disease Control and Prevention’s WONDER database. This database tracks all recorded fatalities in the country including where, when and how they occurred.
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The researchers found that in 2021, almost a third of drug overdose deaths involved both fentanyl and a stimulant like cocaine or methamphetamine. That is a 50-fold increase from 2010 when less than 1 per cent of overdose deaths were attributed to the drug combination. They also found that by 2021, stimulants were the most common drugs involved in fentanyl-related overdose deaths in every US state. Previously, overdose deaths involving fentanyl usually occurred alongside prescription opioids, alcohol and heroin.
“Most of the US, especially the western US, is now dominated by [concurrent] meth and fentanyl use,” says Shover. “In the eastern US, it is more common to see cocaine co-involved with fentanyl.”