https://orcid.org/0000-0002-7077-2810
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Adina Badea, Clinical Laboratories Confront a New Wave of Drug Overdose Deaths, Clinical Chemistry, Volume 70, Issue 8, August 2024, Pages 1085–1086, https://doi.org/10.1093/clinchem/hvae029
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The United States opioid epidemic has evolved over time to involve other classes of drugs and has become a polydrug overdose crisis. Over the course of 4 decades, the shifts in the number of overdose deaths have been characterized as “waves,” based on the drugs primarily responsible for each rise in overdose deaths. The first wave, starting in the late 1990s and early 2000s, was attributed to prescription opioids. The second wave, starting in 2010, was driven by increasing numbers of cases involving heroin, and the third wave, starting in 2013, was driven by fentanyl and its illicit analogs. A recent study (1) has characterized a fourth wave of overdose deaths and addresses the role of polysubstance use in fatal overdoses involving illicit opioids (Fig. 1).
This study examined finalized death records from 2010 through 2021 from the Centers for Disease Control and Prevention (CDC)’s Wide-Ranging Online Database for Epidemiologic Research to provide an in-depth, multivariable characterization of trends in overdose deaths in the United States. The study focused on the role of fentanyl and stimulants as factors shaping the dramatic shifts in overdose deaths. From 2010 to 2021, there was a significant rise in overdose fatalities, from 38 329 to 106 699. As the overall number of overdose deaths rose during the study period, so did the percentage involving both fentanyl and stimulants, from 0.6% in 2010 to 32.3% in 2021. In 2010, fentanyl occurred most frequently in copositivity with opioids, followed by alcohol, and benzodiazepines, across all states. The shift to stimulants as a major co-occurrence in fentanyl deaths followed different timelines in the 4 major geographic regions considered.
