The proportion of deaths from overdoses of fentanyl combined with stimulants in the United States increased more than 50 times between 2010 and 2021, going from 0.6% to 32.3% of deaths, indicates research published this Thursday in the journal Addiction.
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Deaths from this mixture during the so-called “fourth wave” of the opioid overdose crisis jumped from 235 to 34,429 in that periodnoted the study led by the University of California-Los Angeles (UCLA).
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“We see that the use of fentanyl with stimulants is rapidly becoming the dominant force in the overdose crisis in the United States,” said Joseph Friedman, lead author of the study and a researcher at the David Geffen School of Medicine at UCLA, in a statement. University.
He explained that Fentanyl “has ushered in a polysubstance overdose crisis, meaning people are mixing fentanyl with other drugs, such as stimulants, but also countless other synthetic substances.”.
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“This presents many health risks and new challenges for healthcare workers. We have data and medical experience for the treatment of opioid use disorders, but comparatively little experience with combining opioids and stimulants, or opioids mixed with other drugs.” , he explained.
For the researcher, “This makes it difficult to medically stabilize people who are moving away from polysubstance use”.
The analysis highlights how a first wave in the US opioid crisis began with a rise in deaths from prescription opioids in the early 2000s, and a second wave with heroin in 2010.
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This increase constitutes the ‘fourth wave’ in the prolonged opioid overdose crisis in the United States, whose death toll continues to rise precipitously.
Around 2013 an increase in fentanyl overdoses marked the third wave, while the fourth (fentanyl overdose with stimulants) began in 2015 and continues to grow.
By 2021, stimulants such as cocaine and methamphetamines have become the most common class of drugs found in overdoses involving fentanyl in every state in the United States.
“This increase in deaths from fentanyl and stimulants constitutes the ‘fourth wave’ in the long-standing opioid overdose crisis in the United States, whose death toll continues to rise precipitously,” UCLA said.
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To complicate things, Polysubstance users may also be at higher risk of overdose, and many substances laced with fentanyl do not respond to naloxone, the antidote for opioid overdoses..
The authors also found that fentanyl and stimulant overdose deaths disproportionately affect minorities.
For example, in 2021 the presence of stimulants in fentanyl overdose deaths in the Western United States was 73% among African American women ages 65 to 74 and 69% among African American men ages 55 to 65. The proportion in the general US population was 49%.
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There are also geographic patterns in fentanyl and stimulant use. In the northeast of the country, fentanyl tends to be combined with cocaine, while in the southern and western regions it appears to be more associated with methamphetamines.
Friedman said he and his colleagues suspect this reflects the growing availability of low-cost, high-purity methamphetamine throughout the United States “and the fact that the Northeast region has an entrenched pattern of illicit cocaine use that has so far resisted complete emergence of methamphetamine that is seen in the rest of the country.
EFE
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