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. Author manuscript; available in PMC: 2021 May 4.
Published in final edited form as: Nat Med. 2020 May 4;26(5):699–704. doi: 10.1038/s41591-020-0855-y

Figure 4.

Figure 4.

Three phases of overdose deaths revealed by plotting of the estimated peak age of overdose mortality versus the estimated peak amplitude of the overdose mortality rate, for all fifty-one birth-year cohorts 1940-1990 (A). Phase I – increasing peak mortality rates among Baby Boomer birth-year cohorts (1945-1964), Phase II – youth-ward shift among Generation X birth-year cohorts (1965-1980), and Phase III – increasing mortality rates among Millennial birth-year cohorts (1981-1990). Confidence bounds are provided in the supplemental materials Extended Data 3. These three generational phases correspond to the previously recognized three opioid drug waves of prescription opioids, heroin, and fentanyl (B). For each drug wave, the phase with the highest mortality rate in that drug wave is marked with an asterisk (*).