Experts Warn of “Fourth Wave” of Opioid Overdose Deaths in the U.S. Due to Increased Fentanyl Use
A recent study published in the journal Addiction by UCLA researchers has revealed that the U.S. is currently experiencing a “fourth wave” of opioid overdose deaths, primarily caused by a surge in the use of fentanyl. The study found that the combination of fentanyl, a synthetic opioid, and stimulants has increased by more than 50-fold between 2010 and 2015, resulting in a significant rise in overdose deaths.
Lead author of the study, Joseph Friedman, an addiction researcher at the David Geffen School of Medicine at UCLA, stated that the use of fentanyl mixed with stimulants has rapidly become the leading cause of the U.S. overdose crisis. Previous waves of opioid overdose deaths occurred in the early 2000s with the rise of prescription opioids, in 2010 with the mix of heroin and fentanyl, and in 2013 with the use of fentanyl alone.
The fourth wave of opioid overdose deaths began in 2015 when fentanyl started being mixed with stimulants. Initially, fentanyl was commonly mixed with prescription opioids, benzodiazepines, and alcohol. However, by 2021, it was primarily found in stimulants such as cocaine in the Northeast and methamphetamine in the rest of the country. The study also found that nearly every state experienced a significant increase in fentanyl-stimulant overdose deaths between 2015 and 2021.
The study revealed that certain racial groups were disproportionately affected by these overdose deaths. In western states, the share of overdose deaths involving fentanyl-stimulant combinations was 73% among Black or African American women and 69% among Black or African American men between 55 and 65 years old, compared to 49% across the entire country.
The combination of fentanyl and stimulants poses unprecedented dangers for drug users and challenges for healthcare providers. Polysubstance use has become the norm in the last decade, making it difficult to stabilize individuals withdrawing from multiple substances. Dr. Adam Scioli, the medical director and head of psychiatry at Caron Treatment Centers in Philadelphia, emphasized the need for families and individuals to have Narcan, an opioid overdose reversal drug, readily available in case of an overdose.
In 2021, yearly overdose deaths exceeded 100,000 for the first time, with synthetic opioids like fentanyl being involved in over 75% of these deaths. Moreover, many of the polysubstances mixed with fentanyl do not respond to naloxone, the antidote for opioid overdose. Experts warned that the situation may worsen with the emergence of more dangerous fentanyl analogs and other opioids, such as nitazenes and xylazine, which lack effective antidotes.
Dr. Lawrence Weinstein, the chief medical officer of American Addiction Centers, highlighted the need for a collective effort among various entities to address the escalating opioid crisis. He cautioned that without comprehensive action, the surges in overdose deaths are likely to continue, bringing grave consequences for individuals and communities across the nation.