Drug and alcohol dependence · 2026
Declines in stimulant-involved overdose mortality occurred only with fentanyl co-involvement, United States, 2023-2024.
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Busch Daniel A
Аннотация
BACKGROUND: Between 2023 and 2024, overdose mortality in the United States declined substantially. It is unclear whether declines in stimulant-involved overdose mortality reflect changes in stimulant-related mortality independent of fentanyl co-involvement.
METHODS: We analyzed U.S. overdose mortality data from CDC WONDER for 2023 and 2024, stratifying stimulant-, cocaine-, psychostimulant-, and non-fentanyl opioid-involved deaths by fentanyl co-involvement (assigned ICD-10 multiple-cause code T40.4). Mortality rate ratios comparing 2024 with 2023 were calculated.
RESULTS: The decline in stimulant-involved overdose mortality was observed only among deaths with fentanyl co-involvement. Similar patterns were observed for both cocaine- and psychostimulant-involved mortality. In contrast, non-fentanyl opioid-involved mortality declined both with and without fentanyl co-involvement, but the overall decline was predominantly associated with deaths with fentanyl co-involvement.
CONCLUSIONS: The recent decline in stimulant-involved overdose mortality was confined to deaths with fentanyl co-involvement. Non-fentanyl opioid-involved mortality declined in both strata, but the overall decline was predominantly associated with deaths with fentanyl co-involvement. These findings underscore the importance of stratifying category-specific overdose mortality by fentanyl co-involvement.
METHODS: We analyzed U.S. overdose mortality data from CDC WONDER for 2023 and 2024, stratifying stimulant-, cocaine-, psychostimulant-, and non-fentanyl opioid-involved deaths by fentanyl co-involvement (assigned ICD-10 multiple-cause code T40.4). Mortality rate ratios comparing 2024 with 2023 were calculated.
RESULTS: The decline in stimulant-involved overdose mortality was observed only among deaths with fentanyl co-involvement. Similar patterns were observed for both cocaine- and psychostimulant-involved mortality. In contrast, non-fentanyl opioid-involved mortality declined both with and without fentanyl co-involvement, but the overall decline was predominantly associated with deaths with fentanyl co-involvement.
CONCLUSIONS: The recent decline in stimulant-involved overdose mortality was confined to deaths with fentanyl co-involvement. Non-fentanyl opioid-involved mortality declined in both strata, but the overall decline was predominantly associated with deaths with fentanyl co-involvement. These findings underscore the importance of stratifying category-specific overdose mortality by fentanyl co-involvement.