Surge in Deaths Involving Co-Use of Stimulants Plus Opioids

TOPLINE:

Drug-related deaths involving co-use of stimulants and opioids has surged in the US and Canada, with a higher annual rise in drug-related mortality than use of opioids or stimulants alone, a new study showed. Researchers said the findings point to a “silent epidemic” that warrant action by policymakers to increase awareness.

METHODOLOGY:

• US data regarding opioid and stimulant overdose-related trends for unintentional and intentional deaths from 1999 to 2021 were collected from the National Institute on Drug Abuse.
• Canadian data on opioid (2016-2022) and stimulant (2018-2022) overdose-related trends for unintentional and intentional deaths were obtained from the Public Health Agency of Canada and Alberta Substance Use Surveillance System.
• Google Trends relative search interest (RSI) was used to measure public interest over time (2004-present) for search terms related to opioids and psychostimulants.
• Opioid- and stimulant-related death trends and the potential relationship between RSI and drug-related deaths were evaluated.

TAKEAWAY:

• Deaths involving the use of both opioids and stimulants surged in the US, with the annual percent change (APC) increasing from 10.03 for 1999-2006 to 31.99 for 2013-2021. The APC for co-use deaths in Canada for 2018-2022 was 21.38.
• In the US, deaths related to opioid use alone increased in the US from an APC of 11.07 for 1999-2006 to 26.05 for 2019-2021, while deaths related to stimulant use alone rose from 11.65 for 1999-2006 to 26.24 for 2013-2021. In Canada, the APCs were 17.60 for opioid-related deaths for 2016-2022 and 18.24 for stimulant-related deaths for 2018-2022.
• Google search trends did not correlate with the APCs as opioids had a higher overall RSI vs stimulants.
• The highest peak of opioid-related search interest occurred in 2016 in the US and 2015 in Canada, while cocaine-related searches peaked in 2004 and 2005, respectively.

IN PRACTICE:

“There is a need for increased awareness and understanding of the evolving nature of the opioid crisis and the deleterious effects of stimulant co-involvement, especially among the general population,” the investigators wrote.

“These findings are a call to action for public health policymakers to develop strategies for addressing both opioid and stimulant use epidemics simultaneously,” they added.

SOURCE:

The study was led by Yutong Li, University of Alberta, Edmonton, Canada. It was published online on July 16 in PLOS Mental Health.

LIMITATIONS:

Key limitations included insufficient data from Canada because collection only started in 2016, not accounting for substance use beyond opioid and stimulant co-involvement and potential discrepancies between recorded data and actual substance use, which may have led to underestimation of prevalence and overdose incidents. Regional variations in substance use trends and reporting inconsistency were not fully accounted for in national-level data. Additionally, the continuously evolving landscape of substance use, with new synthetic drugs and contaminants, may not have been adequately captured in surveillance data.

DISCLOSURES:

The study was funded by the Canadian Institutes of Health Research, Alberta Innovates, Canada Research Chairs program, Institute for Advancements in Mental Health, Mental Health Foundation, Mental Health Research Canada, MITACS Accelerate program, Simon & Martina Sochatsky Fund for Mental Health, Howard Berger Memorial Schizophrenia Research Fund, Abraham & Freda Berger Memorial Endowment Fund, Alberta Synergies in Alzheimer’s and Related Disorders program, the University Hospital Foundation, and the University of Alberta. The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.