A UCLA study finds that overdose deaths related to fentanyl and meth have increased 50-fold in the U.S. since 2010, marking an alarming “fourth wave” in the opioid crisis. . The rise in polysubstance use poses unique challenges to health care, including disproportionately affecting racial minorities and regional differences in drug combinations.
The trend marks the fourth wave of the U.S. overdose crisis, which began with prescription opioid deaths in the early 2000s and has continued with other drugs.
new University of California Los Angeles-Led study finds that both contribute to the highest percentage of overdose deaths in the United States. fentanyl Since 2010, stimulants have increased more than 50 times, from 0.6% (235 deaths) in 2010 to 32.3% (34,429 deaths) in 2021.
By 2021, stimulants such as cocaine and methamphetamine were the most common drug class found in fentanyl-related overdoses in U.S. states. This increase in fentanyl/meth deaths constitutes the “fourth wave” of the long-running opioid overdose crisis in the United States, and the death toll continues to rise rapidly.
experts give their opinions
“The combination of fentanyl and stimulants is now rapidly becoming a dominant force in the U.S. overdose crisis,” said lead author Joseph Friedman, an addiction researcher at the David Geffen School of Medicine at the University of California, Los Angeles. I know that,” he said.
“Fentanyl is multi-substance This means people are mixing fentanyl with other drugs such as meth, as well as countless other synthetic substances. This poses many health risks and new challenges for healthcare providers. Although we have data and medical expertise on treating opioid use disorder, we have relatively little experience with combining opioids with stimulants or mixing opioids with other drugs. This makes it difficult to medically stabilize people who are refraining from polysubstance use. ”
The study results were published in a peer-reviewed journal on September 13th. Dependence.
A simplified diagram of the four waves of the U.S. overdose death crisis. Waves 1 and 2 include deaths associated with commonly prescribed opioids and heroin, respectively, but do not include deaths associated with co-administration with fentanyl. Waves 3 and 4 show clear trends in non-meth-related and meth-related fentanyl deaths, respectively. Data from CDC WONDER. Credit: Friedman and Shover, 2023, doi: 10.1111/add.16318
Timeline of the opioid crisis
This analysis shows that the U.S. opioid crisis began with an increase in deaths from prescription opioids in the early 2000s (first wave) and heroin in 2010 (second wave). Around 2013, an increase in fentanyl overdoses signaled a third wave. The fourth wave of meth-induced fentanyl overdoses began in 2015 and continues to grow.
Further complicating matters, people who take multiple substances may be at increased risk of overdose, and many substances mixed with fentanyl react with naloxone, the antidote to opioid overdoses. Don’t do it.
Demographic and geographic trends
The authors also found that fentanyl/meth overdose deaths disproportionately impact racial/ethnic minority communities in the United States, including Blacks, African Americans, and Native Americans. For example, in 2021, meth was responsible for fentanyl overdose deaths in 73% of non-Hispanic black or African American women ages 65 to 74 living in the Western United States; It was 69%. Black or African American older men living in the same area. In 2021, it accounted for 49% of the general U.S. population.
There are also geographic patterns in fentanyl/meth use. In the northeastern United States, fentanyl tends to be used in conjunction with cocaine. It most commonly occurs in association with methamphetamine in the southern and western United States.
“This pattern reflects the increasing availability and preference for low-cost, high-purity methamphetamine across the United States, and the Northeast has a persistent pattern of illicit cocaine use that has so far resisted full regulation. “We suspect that this reflects the reality. Methamphetamine takeovers are seen elsewhere in the country as well,” Friedman said.
References: “Graphing the Fourth Wave: Geographic, Temporal, Racial/Ethnic, and Demographic Trends in Multisubstance Fentanyl Overdose Deaths in the United States, 2010-2021,” by Joseph Friedman and Chelsea L. Shover; September 13, 2023 Dependence.
DOI: 10.1111/add.16318
This study was funded by the UCLA Medical Scientist Training Program (National Institute of General Medical Sciences Training Grant GM008042) and the National Institute on Drug Abuse. National Institutes of Health (K01DA050771). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
