Fentanyl-laced overdose deaths have risen 50-fold since 2010, study finds

Overdose deaths in the U.S. involving fentanyl and stimulants have increased more than 50-fold since 2010, a new study found. 

Published in the peer-reviewed journal Addiction Thursday, researchers say 235 deaths due to this mix of drugs occurred in 2010 (0.6%) compared with 34,429 deaths in 2021 (32.3%).

“We’re now seeing that the use of fentanyl together with stimulants is rapidly becoming the dominant force in the US overdose crisis,” lead author Joseph Friedman said in a news release. “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.”

Friedman noted this shift, which the authors described as the “fourth wave” of the country’s opioid crisis, poses both risks and challenges for health care 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,” he said. “This makes it hard to stabilize people medically who are withdrawing from polysubstance use.”

Fentanyl is a synthetic opioid, akin to morphine but more potent, which is sometimes abused on its own or found laced in other drugs

Earlier this year, fentanyl-laced pills made headlines as the cause of death of Leandro De Niro-Rodriguez, an actor and the grandson of Robert De Niro.

Health officials, including those at the U.S. Centers for Disease Control and Prevention, have warned in recent years that its prevalence is on the rise, as is its role in overdose deaths nationwide.

In the latest study, researchers found the drugs most commonly used alongside fentanyl shifted throughout the years and depended on the region. For example, in 2010, it was most commonly found alongside prescription opioids, benzodiazepines and alcohol.

“In the Northeast this shifted to heroin-fentanyl co-involvement in the mid-2010s, and nearly universally to cocaine-fentanyl co-involvement by 2021,” the authors wrote. “Universally in the West, and in the majority of states in the South and Midwest, methamphetamine-fentanyl co-involvement predominated by 2021.”

In virtually every state, however, stimulant involvement in fentanyl-involved overdose deaths rose from 2015 to 2021, they noted.

The research also found this fourth wave disproportionally affected ethnic and racial minorities including Black, African American and Native American people.

-Emily Mae Czachor contributed to this report. 

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