Charting the fourth wave: Geographic, temporal, race/ethnicity and demographic trends in polysubstance fentanyl overdose deaths in the United States, 2010–2021.

Aims: To characterize polysubstance death in the United States during the transition to the fourth wave of the drug overdose crisis. To characterize co‐involved substances in fatal overdose involving synthetic opioids (mainly illicitly manufactured fentanyl analogues) by year, state, and intersectio...

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Publicado en:Addiction Vol. 118; no. 12; pp. 2477 - 2486
Autores principales: Friedman, Joseph, Shover, Chelsea L.
Formato: pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell Dec2023
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Charting the fourth wave: Geographic, temporal, race/ethnicity and demographic trends in polysubstance fentanyl overdose deaths in the United States, 2010–2021.
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        au:
          Friedman, Joseph
          Shover, Chelsea L.
        affil: Center for Social Medicine and Humanities, University of California, Los Angeles California,, USA
      sug:
        subj:
          Overdose Mortality
          Substance Abuse Mortality
          Death Trends
          Geographic Factors Evaluation
          Race Factors Evaluation
          Sociodemographic Factors Evaluation
          Charting
          Human
          Male
          Female
          Adolescence
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          United States
          Fentanyl Adverse Effects
          Central Nervous System Stimulants Adverse Effects
          Record Review
          Death Certificates
          Analgesics, Opioid Adverse Effects
          Antianxiety Agents, Benzodiazepine Adverse Effects
          Ethanol Adverse Effects
          Heroin Adverse Effects
          Cocaine Adverse Effects
          Methamphetamine Adverse Effects
          Funding Source
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Aims: To characterize polysubstance death in the United States during the transition to the fourth wave of the drug overdose crisis. To characterize co‐involved substances in fatal overdose involving synthetic opioids (mainly illicitly manufactured fentanyl analogues) by year, state, and intersectional sociodemographic groups. Design: Population‐based study of national death records. Setting: United States. Participants/cases: All people who died from drug overdose in the United States between 2010 and 2021. Measurements Percentage of all fatal overdose involving fentanyls, stimulants, and other drugs. Most commonly co‐involved substances in fentanyl overdose by state and year. Percentage of fatal fentanyl overdose co‐involving stimulants by state and year. Percentage of fatal fentanyl overdose co‐involving stimulants by intersectional region, race/ethnicity, age, and sex. Findings The percent of US overdose deaths involving both fentanyl and stimulants increased from 0.6% (n = 235) in 2010 to 32.3% (34 429) in 2021, with the sharpest rise starting in 2015. In 2010, fentanyl 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. Universally in the West, and in the majority of states in the South and Midwest, methamphetamine‐fentanyl co‐involvement predominated by 2021. The proportion of stimulant involvement in fentanyl‐involved overdose deaths rose in virtually every state 2015–2021. Intersectional group analysis reveals particularly high rates for older Black and African American individuals living in the West. Conclusions: By 2021 stimulants were the most common drug class found in fentanyl‐involved overdoses in every state in the US. 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 widespread concurrent use of fentanyl and stimulants, as well as other polysubstance formulations, presents novel health risks and public health challenges.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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