Why fentanyl is the leading cause of overdose deaths in the US
Why fentanyl is the leading cause of overdose deaths in the US
Over 150 Americans die every day from overdoses related to fentanyl and synthetic opioids. Here’s why fentanyl is so deadly.
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Illicit fentanyl and methamphetamine
The laboratory Millennium Health said 60% of patients whose urine samples contained fentanyl last year also tested positive for methamphetamine. Cocaine was detected in 22% of the fentanyl-positive samples.
Millennium officials said the report represents the impact of the “fourth wave” of the nation’s overdose epidemic, which began over a decade ago with the misuse of prescription opioids, then came a heroin crisis, and more recently an increase in the use of illicit fentanyl. The study found that people battling addiction are increasingly using illicit fentanyl along with other substances, including stimulants such as methamphetamine and cocaine.
The report suggests heroin and prescription opioids are being abused less often than they were a decade ago. Of the urine samples containing fentanyl analyzed in the report, 17% also contained heroin and 7% showed the presence of prescription opioids.
Regional differences
The Millennium report also found that drug use differed by region, and methamphetamine samples were detected more frequently in the western U.S. Methamphetamine was detected in more than 70% of fentanyl-positive urine samples in the Pacific and Mountain West states. Meth showed up least often in fentanyl-positive samples in the mid- and south-Atlantic states, the report said.
Cocaine appeared to be more prevalent in the eastern U.S. More than 54% of fentanyl-positive samples in New England also had cocaine. By comparison, fewer than 1 in 10 of the samples showed cocaine in the mountain region of the West, the report said.
Implications and treatment options
As methamphetamine use appears to play a larger role in the addiction crisis, the medical community does not have the same tools to counter its misuse. Naloxone and similar overdose reversal medications counteract opioid overdoses by blocking opioid receptors in the brain to quickly reverse the effects of an overdose. However, there is no medication approved by the Food and Drug Administration for overdoses involving stimulants such as methamphetamine.
Opioid substitute medications like methadone and buprenorphine are used to reduce cravings and ease withdrawal symptoms from opioids. However, there are no equivalent medications for people who are dependent on methamphetamine or other stimulants. This highlights the urgent need for effective treatments for stimulant-use disorder.
Increasing overdose deaths
Drug overdose deaths in the United States surged past 100,000 in 2021 and continued to increase in 2022. Stimulants, mostly methamphetamine, are increasingly involved in fentanyl overdoses. In 2021, stimulants were detected in about 1 in 3 fentanyl overdose deaths, compared with just 1 in 100 in 2010.
The study conducted by Millennium Health analyzed urine samples collected from more than 4.1 million patients in 50 states from Jan. 1, 2013, to Dec. 15, 2023. 93% of fentanyl samples tested positive for at least one other substance.
The evolving addiction crisis
Nationwide, the addiction epidemic has evolved to a phase in which people are often using multiple substances, not just fentanyl. This polysubstance abuse complicates matters for public health authorities seeking to slow the nation’s overdose deaths. Reports like the one by Millennium Health are crucial in providing researchers with timely data on the nation’s evolving drug use, offering valuable insights on how to address this crisis.
Ken Alltucker
