It is important that community service providers and members of the public have access to information about stimulants to increase awareness of the risks stimulants may pose, how to identify a stimulant overdose, and what resources exist to provide further support or education. The OD2A funds will help states and communities respond more quickly, effectively, and equitably to prevent overdose death and injury. The ten evidence-based strategies highlighted below are actions that states and jurisdictions can take today to prevent overdoses tomorrow. Research can help identify risk and protective factors for overdose and related harms and inform the development of prevention and mitigation strategies, including those implemented through programmatic funding. Research can also assess the effectiveness of interventions that map onto the strategies within CDC’s broad framework.
Successful Strategies for Preventing Opioid Overdose
Opioids—mainly synthetic opioids like illegally made fentanyl–are currently the most represented in overdose deaths. It is important that comprehensive, community-based prevention and response efforts incorporate evidence-based interventions to address differences in drug overdose deaths. Dissemination can be strengthened by partnerships and can be tailored and scaled up to meet local circumstances. The evolving landscape of the U.S. drug overdose epidemic requires continued evaluation of potential risk factors for overdose.
Understanding Drug Overdoses and Deaths
Death rates involving cocaine and psychostimulants, with and without opioids, have increased. Synthetic opioids appear to be the primary driver of cocaine-involved death rate increases, and recent data point to increasing synthetic opioid involvement in psychostimulant-involved deaths. Geography might also play a role in the overlap between employment in certain industries and co-use of opioids with specific stimulants. For instance, data indicate that recent increases in psychostimulant-involved opioid overdose deaths were most rapid in the Appalachian region (9).
- CDC also has created resources for parents and caregivers about the latest substance use and mental health challenges youth may face.
- Expanding syndromic surveillance to better inform overdose prevention efforts and increasing naloxone provision to persons who use stimulants are essential.
- While increases in cocaine-involved deaths in the United States from 2006 seem to be driven by opioids, particularly synthetic opioids, increases in non-fatal and fatal overdoses involving psychostimulants are occurring with and without opioids.
- For overdose deaths, improvements in toxicological testing over time might account for some increases.
Extramural research and non-research funding in the National Center for Injury Prevention and Control (NCIPC) are key mechanisms for meeting the mission to prevent overdose and substance use-related harms. Along with research conducted by CDC, extramural funding supports rigorous research to address Overdose Prevention Research Priorities. CDC public health news, press releases, government public health news, medical and disease news, story ideas, photos. View the Stimulant Guide below to find answers to emerging questions about stimulants in the context of the overdose epidemic in the United States. View the DOSE and SUDORS data dashboards to see the most up-to-date data on overdoses. For more overdose, injury, and violence data sources, visit Data Statistics, and Reporting.
- The NEDS transition from ICD-9-CM to ICD-10-CM/PCS codes probably affected comparisons between overdose ED visits from 2015 to 2016 and also precluded us from performing comparisons in earlier years.
- In this exploratory analysis of multiple cause of death data from 2022, occupations and industries with higher percentages of psychostimulant involvement in synthetic opioid overdose deaths tended to be physically demanding, whereas those with higher percentages of cocaine involvement tended to be less so.
- A recent study among 29 states and the District of Columbia showed the percentage of overdose deaths involving counterfeit pills more than doubled from July 2019 to December 2021, and more than tripled in the Western United States.
- As poisoning codes on ED medical records are influenced by patient self-report or observations by ED personnel 12, inclusion of opioid codes in combination with a stimulant code may be underestimated in ED data, especially in cases where patients use a stimulant unknowingly mixed with fentanyl 23,24.
- Fentanyl mixed with cocaine or methamphetamine poses a substantially heightened risk of overdose among people who only use stimulants or use opioids infrequently and thus lack opioid tolerance 15.
Deaths involving cocaine with and without opioids, 2016–17
Results and project successes will determine the impact of this program and inform future state and national efforts in preventing prescription drug overdoses. Drug overdose deaths, as defined, that have psychostimulants with abuse potential (T43.6) and heroin (T40.1) as a contributing cause. stimulant overdose drug overdose cdc injury center Drug overdose deaths, as defined, that have psychostimulants with abuse potential (T43.6) and any opioid (T40.0, T40.1, T40.2, T40.3, T40.4 or T40.6) as a contributing cause. The rate of cocaine overdose ED visits without opioids decreased 13.6% from 2015 to 2016, from 6.9 to 5.9.
Secondaryanalysis of non-fatal (2006–16) and fatal (2006–17) drug overdose trends, focusing on the most recent years of data available to examine rate changes by demographics (2015–16 for non-fatal and 2016–17 for fatal). Falls are the leading cause of injury and injury death among Americans ages 65 and older (older adults). The Older Adult Fall Prevention At-a-Glance PDF-1 page shows how CDC empowers healthcare providers, public health agencies, older adults, and caregivers to help maintain the health and independence of older adults by preventing falls.
The anticipated funding amounts provided below and in the NOFO appendices are a guide for budget preparation. They are not a requirement for spending levels on each strategy (outside of the items listed on page 3), as jurisdictions will have flexibility in allocation of their overall award amount between the prevention and surveillance components, and within the surveillance strategies. Table S1 Overdose discharge diagnosis and cause of death codes for mortality and emergency department visits. Our mission is to monitor, prevent, reduce, and respond to overdose via a data-driven approach that is anchored to evidence-based and evidence-informed strategies. If you aren’t sure, it is best to treat the situation like an overdose—you could save a life. Administer naloxone or another opioid overdose reversal medication (if available) and then call 911.
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Drug overdose deaths, as defined, that have psychostimulants with abuse potential (T43.6) and synthetic opioids other than methadone (T40.4) as a contributing cause. CDC is addressing this crisis through evidence-based interventions that account for changes in the illegal drug supply, continued threats from illegally made fentanyl and other synthetic opioids, and a rise in deaths involving stimulants and more than one drug. In Pennsylvania, opioid prescribing (as opposed to stimulant prescribing) during the 3 years preceding death was more common among decedents whose overdose deaths involved stimulants and was more common among all decedents, regardless of the drugs contributing to death. These hypothesis-generating findings warrant confirmation but point to a potential role for work-related substance use and overdose prevention interventions. The National Institute for Occupational Safety and Health has developed the Workplace Supported Recovery (WSR) initiative, which guides employers in bolstering the employment and retention of persons with substance use disorders and in facilitating access to treatment (4). The WSR initiative also aims to address the determinants of substance use disorders and overdose through the reduction of work-related risk factors, including occupational injury and work-related stress (4).
Studies have documented that rising cocaine- and psychostimulant-involved overdose deaths increasingly involve opioids, particularly synthetic opioids 2–4. Among cocaine-involved deaths in the United States, synthetic opioid involvement increased from 4% in 2010 to 40% in 2016 5. Death rates involving psychostimulants and synthetic opioids increased 142.8% annually from 2015 to 2017 2. Compared to 2015, 2016 data from the National Forensic Laboratory Information System (NFLIS) indicated a 297% increase in drug submissions (i.e. drug products obtained by law enforcement) containing mixtures of cocaine and IMF and a 134% increase in submissions containing cocaine, fentanyl and heroin 8. Similarly, NFLIS has documented increases in methamphetamine mixed with IMF, heroin and other fentanyl-like substances 8.
These findings point to the importance of ensuring that the response to the opioid overdose crisis is sufficiently nimble to incorporate evolving drug use patterns. Current efforts to expand medication-assisted treatment for opioid use disorder should consider the polysubstance nature of addiction and incorporate a continuum of treatment and recovery support services targeted to the multiple substances an individual may be using when engaging in treatment. Rates of ED-treated suspected nonfatal drug overdoses involving opioids, cocaine, and amphetamines, and of polydrug overdoses co-involving opioids and amphetamines increased from 2018 to 2019.
Consistent with prior research, opioids constituted a large percentage of drug overdoses overall and were substantially co-involved with stimulant overdoses (2). Notably, rates of suspected overdoses co-involving opioids and amphetamines significantly increased from 2018 to 2019, overall, and in both sexes and nearly all age groups. Findings are consistent with previous studies that have highlighted increases in methamphetamine use initiation,††††† co-use between stimulants and opioids (6,7), nonfatal stimulant-involved overdoses treated in EDs (8), and co-involvement of opioids and stimulants in overdose deaths (9). In 2016, 27% of overdose ED visits involving cocaine and 14% involving psychostimulants also involved a reported opioid. In 2017, almost 75% of overdose deaths involving cocaine and half involving psychostimulants involved at least one opioid.
This also underscores the importance of naloxone access not onlyamong individuals knowingly using opioids, but also among individuals using other illicit drugs that might be contaminated with IMF 16. In 2017, among 70,237 drug overdose deaths that occurred in the United States, 13,942 (19.8%) involved cocaine, representing a 34.4% increase from 2016 (Table). Nearly three fourths (72.7%) of cocaine-involved deaths in 2017 also involved opioids.
During 2016–2017, the age-adjusted rate for psychostimulant-involved deaths increased by 33.3%. Approximately half (50.4%) of psychostimulant-involved deaths also involved opioids in 2017. Psychostimulant-involved death rates increased among both sexes and among persons aged ≥15 years, whites, blacks, non-Hispanic American Indians/Alaska Natives (AI/AN), non-Hispanic Asian/Pacific Islanders (A/PI), and Hispanics. Among racial/ethnic groups, the largest relative rate increase occurred among whites (40.0%), whereas AI/AN experienced the largest absolute rate increase (1.6 per 100,000) and the highest death rate (8.5) in 2017. Counties in medium metro areas experienced the largest absolute rate increase (1.3 per 100,000), and the largest relative rate increase (46.4%). Among Census regions, both the largest relative increase (63.2%) and the largest absolute rate increase (1.2) occurred in the Midwest, whereas the highest psychostimulant-involved death rate (5.3) occurred in the West.
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