Encouraging reports suggest that the tsunami of fentanyl-involved overdose deaths in the U.S. may finally be receding after rising for more than a decade. Fentanyl detection rates have fallen somewhat but fentanyl-associated polysubstance use remains a significant—and still growing—issue that continues to evolve. In addition, overdose mortality data increasingly point to the co-involvement of stimulants (i.e., methamphetamine and cocaine) in fentanyl-related deaths, which has been referred to as the “fourth wave” of the overdose epidemic.
Considering the current and emerging opioid and stimulant use patterns, this presentation will discuss trends in fentanyl positivity rates across the nation and will also focus on the co-detection of methamphetamine, cocaine, and prescription opioids in the population using fentanyl. In addition, positive changes in stimulant use in that same population from more recent times (2023 to 2024) will be compared and discussed. This presentation will also touch on the rising tide of heroin use, particularly in those using fentanyl, and consider recent positivity rate changes. Finally, the most co-detected drugs consumed in the population using fentanyl, over both time and geographical location, will be highlighted.
