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Research Summary

Fentanyl, Stimulant Overdose Deaths Increase 50-Fold in More Than a Decade

In a recent study1, researchers have provided a detailed look at, what they are calling the “fourth wave” of the illicit drug overdose crisis in the United States. According to their findings, the proportion of overdose deaths due to fentanyl and stimulants has increased 50-fold from 2010 to 2021.

Prior to what the researchers consider the “fourth wave” of illicit drug overdoses involving fentanyls, stimulants, and other drugs, there were waves of rising overdose deaths in the United States due to prescription opioids (first wave), heroin-related overdoses (second wave), and synthetic opioids, specifically illicit fentanyl (third wave).2

The researchers conducted a population-based study that measured the percentage of fatal overdoses that involved fentanyls, stimulants, and other drugs. They further broke down their data by year, state, and intersectional sociodemographic groups.

Overall, the researchers found that overdose deaths involving both fentanyl and stimulants increased from 0.6% (n = 235) in 2010 to 32.3% (n = 34,439) in 2021. Additionally, the researchers noted, there was a sharp rise in overdose deaths starting in 2015.

In 2010, based on the data, fentanyl was most commonly found alongside the use of prescription opioids, benzodiazepines, and alcohol. The proportion of the involvement of stimulants in fentanyl-involved overdose deaths rose in every state from 2015 to 2021.

“The rise of deaths involving cocaine and methamphetamine must be understood in the context of a drug market dominated by illicit fentanyls, which have made polysubstance use more sought-after and commonplace,” the researchers concluded. “The widespread concurrent use of fentanyl and stimulants, as well as other polysubstance formulations, presents novel health risks and public health challenges.”

 

Reference:

  1. Friedman J, Shover CL. Charting the fourth wave: Geographic, temporal, race/ethnicity and demographic trends in polysubstance fentanyl overdose deaths in the United States, 2010–2021. Addiction. 2023;118(12):2477-2485. doi:10.1111/add.16318
  2. Ciccarone D. The rise of illicit fentanyls, stimulants and the fourth wave of the opioid overdose crisis. Curr Opin Psychiatry. 2021;34(4):344-350. doi: 10.1097/YCO.0000000000000717