Experts are observing a fourth phase of the deadly epidemic. Nationwide, illicit stimulants mixed with fentanyl were the most common drugs found in fentanyl-related overdoses.
In the U.S., the first wave of the long-running and devastating opioid epidemic began with the abuse of prescription painkillers (early 2000s); the second wave involved an increase in heroin use, starting around 2010.
The third wave began when powerful synthetic opioids like fentanyl started appearing in the supply around 2015.
Now experts are observing a fourth phase of the deadly epidemic. Nationwide, illicit stimulants mixed with fentanyl were the most common drugs found in fentanyl-related overdoses, according to a study published in 2023 in the scientific journal Addiction.
The stimulant in the fatal mixture tends to be cocaine in the Northeast, and methamphetamine in the West and much of the Midwest and South.
“The number one thing that people in the U.S. are dying from in terms of drug overdoses is the combination of fentanyl and a stimulant,’’ said Joseph Friedman, a researcher at UCLA and the study’s lead author.
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