Illicit fentanyl, the driving force behind the U.S. overdose epidemic, is increasingly being used in conjunction with methamphetamine, a new report shows. The laboratory Millennium Health said that 60% of patients whose urine samples contained fentanyl last year also tested positive for methamphetamine. Cocaine was detected in 22% of the fentanyl-positive samples, USA Today reports. Millennium officials said the report represents the impact of the "fourth wave" of the nation's overdose epidemic, which began over a decade ago with the misuse of prescription opioids, then came a heroin crisis and more recently an uptick in illicit fentanyl. The study found that people battling addiction are increasingly using illicit fentanyl along with other substances, including stimulants such as methamphetamine and cocaine. The report suggests both heroin and prescription opioids are being abused less often than they were a decade ago. Of the urine samples containing fentanyl analyzed in the report, 17% also contained heroin and 7% showed the presence of prescription opioids.
The Millennium report is based on analyses of urine samples collected from more than 4.1 million patients in 50 states between Jan. 1, 2013 and Dec. 15, 2023. The samples were collected in doctors' offices and clinics that see patients for pain, addiction and behavioral health treatment. Overall, 93% of fentanyl samples tested positive for at least one other substance, a concerning finding, said Dr. Nora Volkow, director of the National Institute on Drug Abuse. U.S. drug overdose deaths surged past 100,000 in 2021 and increased again in 2022. Provisional data from the Centers for Disease Control and Prevention showed overdose deaths through September 2023 increased about 2% compared with the prior year. Other reports show that stimulants, mostly methamphetamine, are increasingly involved in fentanyl overdoses. In 2021, stimulants were detected in about 1 in 3 fentanyl overdose deaths compared with just 1 in 100 in 2010.