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Fentanyl-Meth Combination Creates ‘Fourth Wave’ of Overdoses

The pairing of meth, which can also cause psychosis and erratic, risky behavior, and opioids like fentanyl, of which small doses can prove fatal, is among the nation’s fastest-rising causes of overdose deaths, the Wall Street Journal reports. One in five of the total fatal overdoses last year involved an opioid and a psychostimulant, a drug class dominated by meth, preliminary federal data show. A decade earlier, about two percent of drug deaths involved such combinations. Meth on its own can cause potentially fatal heart damage and sometimes acute overdoses, and meth-related deaths are broadly surging. Mixing its use with powerful opioids such as fentanyl can be even deadlier. Close to two-thirds of the people who died while on psychostimulants last year also had opioids in their systems.


The synthetic opioid has spread to every corner of the illegal drug market and is driving overdose deaths to records. Sometimes meth users are accidentally exposed to fentanyl. Many users are purposefully using meth and opioids simultaneously or in sequence in search of balancing or offsetting effects, researchers say. Meth, a stimulant that makes people feel energized, also can make it easier for users to consume greater quantities of opioids, said Christopher Jones of the Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control. And mental-health issues that meth sometimes causes—such as paranoia and hallucinations—can compound risks for dual users, researchers say. The rise in fatalities involving stimulants, often combined with opioids, has created a fourth wave of the decades-long U.S. overdose-death crisis, according to Dr. Daniel Ciccarone, a professor of addiction medicine at the University of California, San Francisco. Deaths from combinations of opioids and cocaine, another stimulant, are also climbing.

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