The U.S. is facing a serious opioid crisis, with overdose deaths reaching over 100,000 in 2021. The main cause of these deaths is the combination of stimulants, like cocaine or methamphetamine, with the powerful synthetic opioid fentanyl. This combination, known as polysubstance overdoses, has become increasingly prevalent since 2010. Synthetic opioids now account for 75% of overdose deaths.
The specific stimulant combined with fentanyl varies by region. In the Northeast, it is primarily cocaine, while in the West and the Midwest, it is methamphetamine. The rise of these combinations is a concerning trend, as fentanyl is 50 times stronger than heroin and can easily lead to fatal overdoses.
Combining stimulants with fentanyl can prolong feelings of euphoria and counteract the effects of each drug. Unfortunately, there are limited treatment options for stimulant use disorder, making it challenging to address this problem effectively. California has implemented a pilot program called contingency management, which provides small incentives for abstaining from cocaine or methamphetamine use.
Research is ongoing to find effective treatments for stimulant use disorder, including the exploration of medications like cariprazine. Public health experts are working to better understand the evolving overdose crisis and implement strategies to prevent overdoses and provide appropriate treatment.
While there have been warnings about fentanyl laced with other substances like the animal tranquilizer xylazine, fentanyl remains the primary driver of overdose deaths. Addressing the opioid crisis continues to be a significant public health challenge.
